Individual
JOHN A DEMOPULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 FOREST LN STE B216, DALLAS, TX 75230
(972) 566-8380
(972) 566-8330
Mailing address
7777 FOREST LN STE B216, DALLAS, TX 75230-6810
(972) 566-8380
(972) 566-8330
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
H8543
TX
207R00000X
Internal Medicine Physician
H8543
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00500U
MEDICARE ID
TX
05
—
1233587-04
—
TX
Enumeration date
07/25/2006
Last updated
07/02/2018
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