Provider Demographics
NPI:1255836276
Name:DIMOPOULOS, YIANNIS PETROS (MD)
Entity Type:Individual
Prefix:
First Name:YIANNIS PETROS
Middle Name:
Last Name:DIMOPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GIANNIS PETROS
Other - Middle Name:
Other - Last Name:DIMOPOULOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1515 HOLCOMBE BLVD RM G1.3646
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4000
Mailing Address - Country:US
Mailing Address - Phone:832-331-3875
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD RM G1.3646
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:571-279-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-30
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program