MEDICARE: DR. GEORGIOS ZIAKAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0122X	Plastic and Reconstructive Surgery Physician	M7789	TX
2	208200000X	Plastic Surgery Physician	M7789	TX
3	208600000X	Surgery Physician	M7789	TX

General Provider Information

NPI Number	:	1316121205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGIOS ZIAKAS MD

Provider Business Mailing Address
First Line	:	23960 KATY FWY
Second Line	:	STE 130
City	:	KATY
State	:	TX
Zip	:	77494-0892
Country	:	US
Telephone Number	:	281-347-0096
Fax Number	:	281-347-0102

Provider Business Practice Location Address
First Line	:	23960 KATY FWY
Second Line	:	STE 130
City	:	KATY
State	:	TX
Zip	:	77494-0892
Country	:	US
Telephone Number	:	281-347-0096
Fax Number	:	281-347-0102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	05/12/2016

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