Healthcare Provider Details

I. General information

NPI: 1609338417
Provider Name (Legal Business Name): PANAYIOTIS TJIONAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

6431 FANNIN STREET MSB 7.154 DEPARTMENT NEUROSURGERY/NEUROCRITICAL CARE
HOUSTON TX
77030-0001
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-1418
  • Fax: 918-494-1491
Mailing address:
  • Phone: 201-982-1152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number46326
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: