Provider Demographics
NPI:1922150945
Name:SKARIBAS, IOANNIS MIHAIL (MD)
Entity Type:Individual
Prefix:
First Name:IOANNIS
Middle Name:MIHAIL
Last Name:SKARIBAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11451 KATY FWY STE 340
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2009
Mailing Address - Country:US
Mailing Address - Phone:832-862-7246
Mailing Address - Fax:832-862-6777
Practice Address - Street 1:11451 KATY FWY STE 340
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2009
Practice Address - Country:US
Practice Address - Phone:832-862-7246
Practice Address - Fax:832-862-6777
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7615207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00000723OtherRAILROAD- MEDICARE
TXP00692604OtherRAILROAD MEDICARE
TX047721805Medicaid
TX047721806Medicaid
TX8BM991OtherBLUE CROSS BLUE SHIELD ID
8H9231OtherTX-BLUE SHIELD
TXTXB113715Medicare PIN
TXP00692604OtherRAILROAD MEDICARE
H09195Medicare UPIN
TX047721805Medicaid