Provider Demographics
NPI:1740349471
Name:CARAYANNOPOULOS, GEORGE N (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:N
Last Name:CARAYANNOPOULOS
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 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0553
Mailing Address - Country:US
Mailing Address - Phone:409-722-2222
Mailing Address - Fax:409-722-2222
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0553
Practice Address - Country:US
Practice Address - Phone:409-722-2222
Practice Address - Fax:409-722-2222
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2661207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043147002Medicaid
TX043147002Medicaid