Individual
DR. NICOLAS ATHANASSIOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 CITYWEST BLVD STE 300, HOUSTON, TX 77042-2549
(713) 620-4000
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
L3914
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147621003
—
TX
05
—
2315269
—
LA
01
—
P00246625
RAILROAD MEDICARE
TX
Enumeration date
12/04/2006
Last updated
08/25/2020
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