MEDICARE: ALEXANDRA CALOUDAS PH.D.

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	103TC1900X	Counseling Psychologist	37562	TX

General Provider Information

NPI Number	:	1629552872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA CALOUDAS PH.D.

Provider Business Mailing Address
First Line	:	7511 OLYMPIA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-1918
Country	:	US
Telephone Number	:	573-356-5960
Fax Number	:

Provider Business Practice Location Address
First Line	:	4130 BELLAIRE BLVD STE 208
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1056
Country	:	US
Telephone Number	:	713-993-7030
Fax Number	:	713-993-7774

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

Provider Enumeration Date	:	09/23/2018
Last Update Date	:	09/23/2018

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