Provider Demographics
NPI:1962506055
Name:DYLEWSKI, DREW ARIC (MD)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:ARIC
Last Name:DYLEWSKI
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 1:919 GRAHAM DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6408
Mailing Address - Country:US
Mailing Address - Phone:281-516-6530
Mailing Address - Fax:281-290-9824
Practice Address - Street 1:919 GRAHAM DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6408
Practice Address - Country:US
Practice Address - Phone:281-516-6530
Practice Address - Fax:281-290-9824
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6593208800000X
NC200401205208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189535101Medicaid
TX189535101Medicaid
TX8J9364Medicare PIN