MEDICARE: DR. NICOLAS XYDAS WOMENS CENTER 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	207VG0400X	Gynecology Physician	J7734	TX

General Provider Information

NPI Number	:	1811917024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. NICOLAS XYDAS WOMENS CENTER PA

Provider Business Mailing Address
First Line	:	6500 NORTH FWY STE 110
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-2941
Country	:	US
Telephone Number	:	713-695-0002
Fax Number	:	713-695-0101

Provider Business Practice Location Address
First Line	:	6500 NORTH FWY STE 110
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-2941
Country	:	US
Telephone Number	:	713-695-0002
Fax Number	:	713-695-0101

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NICOLAS XYDAS
Credential	:	MD
Telephone Number	:	713-695-0002

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	04/20/2008

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