MEDICARE: VASILIKI VIVIAN DIMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0202X	Pediatric Cardiology Physician	L6032	TX
2	207RA0002X	Adult Congenital Heart Disease Physician	L6032	TX

General Provider Information

NPI Number	:	1639102148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VASILIKI VIVIAN DIMAS MD

Provider Business Mailing Address
First Line	:	7777 FOREST LN STE A337
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-2563
Country	:	US
Telephone Number	:	972-566-5575
Fax Number	:	972-566-5581

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7208
Country	:	US
Telephone Number	:	214-730-5437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	12/02/2025

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