Organization
ANDREAS C. NIKOLAIDIS M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ALLEN (OFFICE COORDINATOR)
(281) 354-5663
Entity
Organization
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 BLUESHIELD
TX
Enumeration date
08/27/2007
Last updated
08/27/2007
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