Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD439130 | PA |
N | 208600000X | Surgeon | MD439130 | PA |
Y | 2086X0206X | Surgical Oncologist | P3051 | TX |
NPI | 1356551782 |
---|---|
Provider Name | Dr. Pavlos Papavasiliou |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75246-2003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 04/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
294803602 | (05) | TX |
372847401 | (05) | TX |
P01314323 | RAILROAD MEDICARE (01) | TX |