Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | J9412 | TX |
N | 207RX0202X | Medical Oncology | J9412 | TX |
NPI | 1033158480 |
---|---|
Provider Name | Dr. Panagiotis N Valilis |
First Address | Dallas, TX 75391-1230 |
Second Address | El Paso, TX 79915-1815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 28/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000K5467 | (05) | NM |
8R1573 | BLUE CROSS OF TEXAS (01) | TX |
J19937 | (02) |