Demetris Allen Green SR. MD

NPI 1699973420 - Family Medicine - 207Q00000X

NPI Details
NPI 1699973420
Gender Male
Enumeration Date 07/03/2007
Last Updated 08/05/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
2646 S LOOP W
SUITE 440
HOUSTON TX, 77054-2665, US
Phone (713) 808-9658
Fax (281) 501-3075
Business Location
2646 S LOOP W
SUITE 440
HOUSTON TX, 77054-2665, US
Phone (713) 808-9658
Fax (281) 501-3075
Toxanomy
Taxonomy Code 207Q00000X
License State Texas
License Number J4168
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According to our database, Dr. Demetris Allen Green SR. MD NPI is 1699973420, taxonomy code is 207Q00000X and license number is J4168, license state is located at Texas. Demetris Allen Green SR. MD physically located at 2646 S Loop W, Houston TX, 77054-2665. NPI Number Demetris Allen Green SR. MD has the Individual type.

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1699973420 NPI number is provided on an as is basis without warranty of any kind. 1699973420 is maintained by the National Plan & Provider Enumeration System. The contents of Demetris Allen Green SR. MD are for informational purposes only.