Provider Demographics
NPI:1174727747
Name:CARAYANNOPOULOS, NIKOLETTA LEONTARITIS (DO)
Entity type:Individual
Prefix:DR
First Name:NIKOLETTA
Middle Name:LEONTARITIS
Last Name:CARAYANNOPOULOS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12606 W HOUSTON CENTER BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2788
Mailing Address - Country:US
Mailing Address - Phone:281-496-2482
Mailing Address - Fax:281-497-8889
Practice Address - Street 1:12606 W HOUSTON CENTER BLVD STE 302
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2788
Practice Address - Country:US
Practice Address - Phone:281-496-2482
Practice Address - Fax:281-497-8889
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5326207X00000X
NC2010-00679207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280495702Medicaid
2757085698OtherMYUTMB 2757085698-COMMERCIAL NUMBER