Provider Demographics
NPI:1942732664
Name:COOMBS, DEMETRIUS M (MD)
Entity Type:Individual
Prefix:
First Name:DEMETRIUS
Middle Name:M
Last Name:COOMBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7777 FOREST LANE
Mailing Address - Street 2:SUITE C-700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2518
Mailing Address - Country:US
Mailing Address - Phone:972-566-6464
Mailing Address - Fax:972-566-6279
Practice Address - Street 1:7777 FOREST LANE
Practice Address - Street 2:SUITE C-700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2518
Practice Address - Country:US
Practice Address - Phone:972-566-6464
Practice Address - Fax:972-566-6279
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
TXU12522086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program