ANDREW PACK MD
NPI 1952104887
Student in an Organized Health Care Education/Training Program in Fort Worth, TX
About Andrew Pack Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW PACK MD (NPI 1952104887) is an individual student in an organized health care education/training program in Fort Worth, Texas and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Andrew Pack Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WORTH, TX 76104
FORT WORTH, TX 76104
FORT WORTH, TX 76104
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Andrew Pack's NPI number?
The NPI number for Andrew Pack is 1952104887. It was assigned to this individual provider in the NPPES registry on March 27, 2025.
Where is Andrew Pack located?
Andrew Pack practices at 1500 S Main St, Fort Worth, TX 76104. The listed phone number is (817) 702-1100.
What is Andrew Pack's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Andrew Pack enrolled in Medicare?
Yes. Andrew Pack is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Andrew Pack was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Andrew Pack, MD · NPI 1952104887
Student in an Organized Health Care Education/Training Program provider in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since March 27, 2025.
## Identity
- **NPI:** 1952104887 (Entity type: Individual)
- **Enumerated:** March 27, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1500 S MAIN ST, Fort Worth, TX 76104-4917
- **Phone:** (817) 702-1100
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 27, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1952104887) · Data from the CMS NPPES public registry.