Provider Demographics
NPI:1043242720
Name:TAGAROPULOS, DEMETRIO P (MD)
Entity Type:Individual
Prefix:
First Name:DEMETRIO
Middle Name:P
Last Name:TAGAROPULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5514
Mailing Address - Country:US
Mailing Address - Phone:713-522-9300
Mailing Address - Fax:713-520-8669
Practice Address - Street 1:1315 ST JOSEPH PKWY
Practice Address - Street 2:SUITE #1700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8233
Practice Address - Country:US
Practice Address - Phone:713-652-5011
Practice Address - Fax:713-450-3988
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0033174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
B26834Medicare UPIN
TX00KB83Medicare ID - Type Unspecified