Provider Demographics
NPI:1043482334
Name:ALEXANDRA SIMOTAS
Entity Type:Organization
Organization Name:ALEXANDRA SIMOTAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMOTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-469-3399
Mailing Address - Street 1:11302 FALLBROOK DRIVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4235
Mailing Address - Country:US
Mailing Address - Phone:281-469-3399
Mailing Address - Fax:281-469-4499
Practice Address - Street 1:11302 FALLBROOK DRIVE
Practice Address - Street 2:SUITE 301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4235
Practice Address - Country:US
Practice Address - Phone:281-469-3399
Practice Address - Fax:281-469-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8841207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190155501Medicaid
TX190155501Medicaid