Provider Demographics
NPI:1053592535
Name:MCGUIRE, ANDREA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:MCGUIRE-GROVNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:1672 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-3898
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1860 S SEGUIN AVE # 205
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3914
Practice Address - Country:US
Practice Address - Phone:830-468-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02708363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y4023OtherBCBS PVN
TX2035487-01Medicaid
TX2988909-01Medicaid
TX00115XMedicare PIN
E60178Medicare UPIN
TX2988909-01Medicaid
TX8Y4023OtherBCBS PVN