Individual
DR. THEMISTOCLES DASSOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3409 WORTH STREET, SUITE 640, DALLAS, TX 75246
(469) 800-7180
(469) 800-7190
Mailing address
3409 WORTH STREET, SUITE 640, DALLAS, TX 75246
(469) 800-7180
(469) 800-7190
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
2008001013
MO
207RG0100X
Gastroenterology Physician
Primary
Q0899
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760488936
GROUP NPI
TX
05
—
3445801-01
—
TX
01
—
7310099
AETNA MEDICARE
TX
Enumeration date
06/17/2006
Last updated
09/02/2016
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