Provider Demographics
NPI:1225020019
Name:KEICHIAN, ANDRES HUGO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:HUGO
Last Name:KEICHIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3003 SOUTH LOOP W
Mailing Address - Street 2:SUITE 505
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1375
Mailing Address - Country:US
Mailing Address - Phone:713-218-9443
Mailing Address - Fax:713-218-9447
Practice Address - Street 1:3003 SOUTH LOOP W
Practice Address - Street 2:SUITE 505
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1375
Practice Address - Country:US
Practice Address - Phone:713-218-9443
Practice Address - Fax:713-218-9447
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE33382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136650210Medicaid
TX136650210Medicaid
TX8F6370Medicare PIN