MEDICARE: ANDRES H KEICHIAN, MD, PA

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	2084N0400X	Neurology Physician	E3338	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366657561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDRES H KEICHIAN, MD, PA

Provider Business Mailing Address
First Line	:	3003 SOUTH LOOP W
Second Line	:	SUITE 505
City	:	HOUSTON
State	:	TX
Zip	:	77054-1375
Country	:	US
Telephone Number	:	713-218-9443
Fax Number	:	713-218-9447

Provider Business Practice Location Address
First Line	:	3003 SOUTH LOOP W
Second Line	:	SUITE 505
City	:	HOUSTON
State	:	TX
Zip	:	77054-1375
Country	:	US
Telephone Number	:	713-218-9443
Fax Number	:	713-218-9447

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANDRES HUGO KEICHIAN
Credential	:	MD
Telephone Number	:	713-218-9443

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	05/27/2010

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