Provider Demographics
NPI:1447496781
Name:DYKOSKI, LAURIE NIX (MD)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:NIX
Last Name:DYKOSKI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2411 FOUNTAIN VIEW DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4817
Mailing Address - Country:US
Mailing Address - Phone:713-620-4000
Mailing Address - Fax:713-620-4098
Practice Address - Street 1:2411 FOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4817
Practice Address - Country:US
Practice Address - Phone:713-620-4000
Practice Address - Fax:713-620-4098
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN3017207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206775301Medicaid
TX8CD179OtherBLUE CROSS BLUE SHIELD
TXP00845809OtherRAILROAD MEDICARE
TX8L19947Medicare PIN