Provider Demographics
NPI:1841364676
Name:DEMETRIOU, DINO J
Entity type:Individual
Prefix:
First Name:DINO
Middle Name:J
Last Name:DEMETRIOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 PASADENA BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77506
Mailing Address - Country:US
Mailing Address - Phone:713-472-1444
Mailing Address - Fax:713-472-8713
Practice Address - Street 1:1120 PASADENA BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77506
Practice Address - Country:US
Practice Address - Phone:713-472-1444
Practice Address - Fax:713-472-8713
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5325111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T91067Medicare UPIN
TX603154Medicare PIN