Healthcare Provider Details

I. General information

NPI: 1922150945
Provider Name (Legal Business Name): IOANNIS MIHAIL SKARIBAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11451 KATY FWY STE 340
HOUSTON TX
77079-2009
US

IV. Provider business mailing address

11451 KATY FWY STE 340
HOUSTON TX
77079-2009
US

V. Phone/Fax

Practice location:
  • Phone: 832-862-7246
  • Fax: 832-862-6777
Mailing address:
  • Phone: 832-862-7246
  • Fax: 832-862-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberK7615
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberK7615
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: