Provider Demographics
NPI:1205368644
Name:FOTOPOULOS, GEORGIOS (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGIOS
Middle Name:
Last Name:FOTOPOULOS
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 1:5114 MEDICAL DR
Mailing Address - Street 2:1305
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3764
Mailing Address - Country:US
Mailing Address - Phone:281-827-8325
Mailing Address - Fax:
Practice Address - Street 1:7979 WURZBACH RD
Practice Address - Street 2:CTRC
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-450-2872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10058614207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology