Provider Demographics
NPI:1376546861
Name:PAPADOPOULOS, KYRIAKOS PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:KYRIAKOS
Middle Name:PETER
Last Name:PAPADOPOULOS
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 1:4383 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3307
Mailing Address - Country:US
Mailing Address - Phone:210-593-5700
Mailing Address - Fax:210-593-5992
Practice Address - Street 1:4383 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3307
Practice Address - Country:US
Practice Address - Phone:210-593-5700
Practice Address - Fax:210-593-5992
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8877207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170957801Medicaid
TX170957803Medicaid
TX8C2220Medicare ID - Type Unspecified
TX170957801Medicaid
TX8J5894Medicare PIN