Provider Demographics
NPI:1679682223
Name:XAVIER, ANDREEA SIMONA (MD)
Entity type:Individual
Prefix:
First Name:ANDREEA
Middle Name:SIMONA
Last Name:XAVIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREEA
Other - Middle Name:
Other - Last Name:POPOVICI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6431 FANNIN JJL 270A
Mailing Address - Street 2:JJL 270A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-704-9389
Mailing Address - Fax:434-982-7752
Practice Address - Street 1:6431 FANNIN JJL 270A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-7703
Practice Address - Country:US
Practice Address - Phone:585-322-5736
Practice Address - Fax:434-982-7581
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244083207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02868477Medicaid
VAMC11101Medicare PIN
NY02868477Medicaid