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Individual

ANDREAS C. NIKOLAIDIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
24375 FM 1314 RD, PORTER, TX 77365-4205
(281) 354-5663
(281) 354-1995
Mailing address
24375 FM 1314 RD, PORTER, TX 77365-4205
(281) 354-5663
(281) 354-1995

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L3042
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0074HX
BLUECROSS BLUE SHIELD
Enumeration date
04/08/2006
Last updated
07/09/2007
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