Healthcare Provider Details
I. General information
NPI: 1699206011
Provider Name (Legal Business Name): LYOS PLASTIC SURGERY & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2017
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9230 KATY FWY SUITE 420
HOUSTON TX
77055-7469
US
IV. Provider business mailing address
9230 KATY FWY SUITE 420
HOUSTON TX
77055-7469
US
V. Phone/Fax
- Phone: 713-799-8989
- Fax: 713-799-9115
- Phone: 713-799-8989
- Fax: 713-799-9115
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207YX0905X |
| Taxonomy | Otolaryngology/Facial Plastic Surgery Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANDREW
LYOS
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 713-799-8989