Organization
DEMETRIS A. GREEN, SR. MD PA
Active
Other names
Sirte Med Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEMETRIS ALLEN GREEN SR. MD (OWNER/MEDICAL DIRECTOR)
(713) 808-9658
Entity
Organization
Contact information
Practice address
2646 S LOOP W, SUITE 220, HOUSTON, TX 77054-2665
(713) 808-9658
(281) 501-3075
Mailing address
2646 S LOOP W, SUITE 220, HOUSTON, TX 77054-2665
(713) 808-9658
(281) 501-3075
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/29/2014
Last updated
12/29/2014
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