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General NPI Number Information
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NPI Number | 1003077561
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Entity Type | Organization
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Legal Business Name | JOHN A. DEMOPULOS, M.D., P.A.
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 7777 FOREST LN STE B216
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City | DALLAS
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State | TX
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Zip | 75230-6810
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Country | US
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Telephone | 972-566-8380
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Fax |
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Provider Business Mailing Address
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Address Line | 7777 FOREST LN STE B216
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City | DALLAS
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State | TX
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Zip | 75230-6810
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Country | US
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Telephone | 972-566-8380
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN A DEMOPULOS
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Credential | M.D,
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Telephone | 972-566-8380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | H8543
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License Number State | TX
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