Individual
LAZAROS A NIKOLAIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
45092
TX
207RC0000X
Cardiovascular Disease Physician
MD056993L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017884500004
—
PA
Enumeration date
10/13/2005
Last updated
01/07/2021
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