Organization
DIMITRIOS MANTZOROS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIMITRIOS MANTZOROS D.P.M. (PHYSICIAN)
(936) 756-9191
Entity
Organization
Contact information
Practice address
100 MEDICAL CENTER BLVD, STE 216, CONROE, TX 77304-2888
(936) 756-9191
Mailing address
100 MEDICAL CENTER BLVD, STE 216, CONROE, TX 77304-2888
(936) 756-9191
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1068
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180128401
—
TX
Enumeration date
09/30/2008
Last updated
04/14/2016
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