Provider Demographics
NPI:1811917024
Name:DR. NICOLAS XYDAS WOMENS CENTER PA
Entity type:Organization
Organization Name:DR. NICOLAS XYDAS WOMENS CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:XYDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-695-0002
Mailing Address - Street 1:6500 NORTH FWY STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-2941
Mailing Address - Country:US
Mailing Address - Phone:713-695-0002
Mailing Address - Fax:713-695-0101
Practice Address - Street 1:6500 NORTH FWY STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-2941
Practice Address - Country:US
Practice Address - Phone:713-695-0002
Practice Address - Fax:713-695-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7734207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID #