Andrew Dewayne Hudson, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

T8561 Issued in TX

Practice address

331 Town PL
Fairview, TX 75069-1825

Phone

(972) 747-0000

NPI assigned

Apr 12, 2019

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Texas Tech University Health Science Center School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Dermatology PLLCGroup PAC ID 2264795673, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Dermatology PLLC

  • Dermatology Physician
  • Fairview, TX
  • NPI 1073014114
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1700349941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 TOWN PL",
            "city": "FAIRVIEW",
            "state": "TX",
            "postal_code": "750691825",
            "telephone_number": "806-570-5338",
            "fax_number": "972-736-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 TOWN PL",
            "city": "FAIRVIEW",
            "state": "TX",
            "postal_code": "750691825",
            "telephone_number": "972-747-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "ANDREW",
        "middle_name": "DEWAYNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "T8561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Michelle Grentz, BSN, RN, IBCLC
• Nessa Zahra Habibi
• Katie Bradford Heitmuller
• Bethany Lyn Hiner, BCBA
• Jamyria Hopkins
• James a Williams, OD, PC
• Jose Ortiz CST
• Helen Kim-James, M.D.
• Patricia Kline, L.P.C.
• Lee W. Ligon, D.C., P.C.

• Dermatology Physician in Fairview, TX
• Providers in Fairview, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.