Provider Demographics
NPI:1104211002
Name:TRIANTAFYLLOU, DINARA
Entity Type:Individual
Prefix:
First Name:DINARA
Middle Name:
Last Name:TRIANTAFYLLOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DINARA
Other - Middle Name:
Other - Last Name:YANGIROVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:ONE BAYLOR PLAZA, BCM350
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-4872
Mailing Address - Fax:
Practice Address - Street 1:ONE BAYLOR PLAZA, BCM350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3411
Practice Address - Country:US
Practice Address - Phone:713-798-4872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD4676102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program