Andrews County
Organization Active NPI Family Medicine Physician · Andrews, TX
NPI 1861488694 · NPPES record last updated Oct 29, 2025
Key facts
- NPI
- 1861488694
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ANDREWS COUNTY
- Practice address
- 208 NW 2ND St
Andrews, TX 79714-6308 - Phone
- (432) 524-1434
- Fax
- (432) 524-1461
- NPI assigned
- Sep 27, 2005
- Organization subpart
- No
Authorized official
- Name
- Gordon Mattimoe, DNP, APRN, FNP-C
- Title
- Authorized Official
- Phone
- (432) 524-1434
Practitioners 7
-
Crystal Gonzalez Ortiz, FNP-C
-
Andrew Managan Allbright, NP-C
-
Mary Lou Cornejo, RN
-
Dorothy Faye Jackson, RN, FNP
-
Debra Lynne McCullough, ADVCD PRACTICE NURSE
-
Linda Kay Tolson, RN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0882632 | Andrews County Health Department | Certificate of waiver | Feb 14, 2028 |
National Provider Directory
Locations
208 NW 2nd St
Andrews, TX 79714
Phone (432) 524-1434
211 NW 1st St
Andrews, TX 79714
Phone (915) 524-1434
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
208 NW 2ND St
Andrews, TX 79714-6308
Mailing address
208 NW 2ND St
Andrews, TX 79714-6308
Phone (432) 524-1434
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 094701202 | Medicaid | TX | |
| 063303402 | Medicaid | TX | |
| 094701201 | Medicaid | TX | |
| 017486401 | Medicaid | TX | |
| 094701203 | Medicaid | TX |
Other providers in Andrews, TX
- Larry Joe Allen
- Ama-Life and Associates
- Andrews 2012 PLLC
- Andrews County Hospital District
- Andrews County Hospital District
- Andrews County Hospital District
- Andrews County Hospital District
- Andrews County Hospital District
All providers in Andrews, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.