Provider Demographics
NPI:1528035656
Name:SIMOTAS, ALEXANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:SIMOTAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 FALLBROOK DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4237
Mailing Address - Country:US
Mailing Address - Phone:281-469-3399
Mailing Address - Fax:281-469-4499
Practice Address - Street 1:11301 FALLBROOK DR
Practice Address - Street 2:SUITE 204
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4237
Practice Address - Country:US
Practice Address - Phone:281-469-3399
Practice Address - Fax:281-469-4499
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8841207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146906603Medicaid
TXH10220Medicare UPIN
TX8B7810Medicare PIN