Healthcare Provider Details

I. General information

NPI: 1235667189
Provider Name (Legal Business Name): LYOS PLASTIC SURGERY & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9230 KATY FWY STE 420
HOUSTON TX
77055-7468
US

IV. Provider business mailing address

9230 KATY FWY STE 420
HOUSTON TX
77055-7468
US

V. Phone/Fax

Practice location:
  • Phone: 713-799-8989
  • Fax: 713-799-9115
Mailing address:
  • Phone: 713-799-8989
  • Fax: 713-799-9115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberJ8038
License Number StateTX

VIII. Authorized Official

Name: ANDREW T LYOS
Title or Position: OWNER
Credential: MD
Phone: 713-799-8989