MEDICARE: DR. ELEFTHERIOS MYLONAKIS MD PHD

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	207RI0200X	Infectious Disease Physician	U1976	TX
2	207RI0200X	Infectious Disease Physician	MD13901	RI

General Provider Information

NPI Number	:	1629041074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELEFTHERIOS MYLONAKIS MD PHD

Provider Business Mailing Address
First Line	:	6550 FANNIN ST STE 1001
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2740
Country	:	US
Telephone Number	:	617-670-9115
Fax Number	:

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST STE 1001
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2740
Country	:	US
Telephone Number	:	617-670-9115
Fax Number	:

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	06/23/2023

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