Individual
DR. THEODOROS KELESIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6201 HARRY HINES BLVD DALLAS, DALLAS, TX 75390-0001
(214) 645-6757
Mailing address
PO BOX 845347 DALLAS TEXAS 75284-7208, DALLAS, TX 75284-7208
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
228456
MA
207R00000X
Internal Medicine Physician
A106957
CA
207RI0200X
Infectious Disease Physician
A106957
CA
207RI0200X
Infectious Disease Physician
Primary
U5140
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043487317
—
CA
Enumeration date
05/14/2008
Last updated
10/23/2023
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