Provider Demographics
NPI:1801897343
Name:LYOS, ANDREW T (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:T
Last Name:LYOS
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 1:9230 KATY FWY
Mailing Address - Street 2:SUITE 420
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7469
Mailing Address - Country:US
Mailing Address - Phone:713-799-8989
Mailing Address - Fax:713-799-9115
Practice Address - Street 1:9230 KATY FWY
Practice Address - Street 2:SUITE 420
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7469
Practice Address - Country:US
Practice Address - Phone:713-799-8989
Practice Address - Fax:713-799-9115
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8038174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPO82J6756Medicaid
TXG03116Medicare UPIN
TX82J675Medicare ID - Type UnspecifiedMEDICARE