Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | D8329 | TX |
Y | 207RX0202X | Medical Oncology | D8329 | TX |
NPI | 1154369775 |
---|---|
Provider Name | Dr. Demetrius F Loukas JR. |
First Address | Dallas, TX 75391-1230 |
Second Address | Austin, TX 78705-1165 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 03/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
135735202 | (05) | TX |
830004591 | RAILROAD MEDICARE NUMBER (01) | TX |
8BP228 | BCBS OF TX (01) | TX |
C18550 | (02) | TX |
P00664385 | RAILROAD MEDICARE (01) | TX |