DEMETRIS ALLEN GREEN MD (NPI# 1669609459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669609459 |
| Entity Type | Organization |
| Organization Name | DEMETRIS ALLEN GREEN MD |
| Practice Address |
10610 Fondren Rd Ste 124 Houston TX 77096-5422 |
| Mailing Address |
8299 Cambridge St Apt 1203 Houston TX 77054-3141 |
| Practice Telephone | 7139815167 |
| Practice Fax Number | 7139815553 |
| Mailing Telephone | 7133839003 |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2009-06-22 |
| Authorized Official Name | DR. DEMETRIS ALLEN GREEN SR. (PHYSICIAN) |
| Authorized Official Telephone | 7133839003 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | J4168 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | US DEPARTMENT OF LABOR | 613884700 | 01 |
| Street Address |
10610 FONDREN RD STE 124 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77096-5422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467825992 | Chandler Injury Rehab Clinic, LLC | Chiropractor | 10610 Fondren Rd, Suite 124, Houston, TX 77096-5422 | 2015-11-05 |
| 1437572088 | Anibal F Rossel, M.d., Pa | Internal Medicine | 10610 Fondren Rd, Suite 124, Houston, TX 77096-5422 | 2014-01-31 |
| 1144641002 | Starlife Ventures, LLC | Physical Medicine & Rehabilitation | 10610 Fondren Rd, Suite 128, Houston, TX 77096 | 2013-12-19 |
| 1255536231 | Lectoy Tarlington Johnson Jr. | Physical Therapist | 10610 Fondren Rd, Suite 124, Houston, TX 77096-5422 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427680420 | Sanitas Medical Center of Texas Pa | Family Medicine | 10101 S Post Rd, Houston, TX 77096 | 2020-02-07 |
| 1679113815 | Ashley Tolbert | Nurse Practitioner | 10101 S Post Oak Rd, Houston, TX 77096 | 2020-01-15 |
| 1992223564 | Elizabeth Olufuwa | Pharmacist | 9555 South Post Oak Road, Houston, TX 77096 | 2017-09-05 |
| 1063967776 | Safer Surgery Iom | Specialist/Technologist, Other | 5300 N Braeswood Blvd #127, Houston, TX 77096 | 2016-08-23 |
| 1811388754 | Dr G Internal Medicine Pa | Clinic/Center | 5895 S Braeswood Blvd, Houston, TX 77096 | 2015-02-13 |
| 1386044287 | Peoples Champ Physical Therapy LLC | Clinic/Center | 8715 South Loop West, Suite E, Houston, TX 77096 | 2014-08-27 |
| 1821403833 | Vicky Chi Vu | Optometrist | 238 Meyerland Plaza, Houston, TX 77096 | 2014-06-27 |
| 1013327279 | Angela Patrick | Pharmacist | 10707 Albury Dr., Houston, TX 77096 | 2014-04-28 |
| 1568702470 | Ks Pharm LLC | Pharmacy | 560 Meyerland Plaza, Houston, TX 77096 | 2013-03-01 |
| 1295081057 | Kathleen Lawson Dreher | Dentist | 4830 Imogene, Houston, TX 77096 | 2012-07-31 |
| Find all providers in zip 77096 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376151472 | Canice Chukwuocha | General Practice | 3030 Elmside Dr Apt 179, Houston, TX 77042-3926 | 2020-07-15 |
| 1902424518 | Medkare | General Practice | 2426 Lake Kolbe Ln, Houston, TX 77080-2562 | 2020-07-09 |
| 1477191757 | Holistic Innovative Interventional Pain Associates Pllc | General Practice | 4615 Southwest Freeway #850, Houston, TX 77027 | 2019-12-17 |
| 1467019109 | Eldere Germain | General Practice | 5850 Duxbury St, Houston, TX 77035-4211 | 2019-05-28 |
| 1235697822 | Joy Ileruwa Ebomwonyi | General Practice | 17567 Imperial Valley Dr, Houston, TX 77060-7706 | 2019-03-04 |
| 1194295030 | Westheimer Medical Group Pllc | General Practice | 5433 Westheimer Rd Ste 275, Houston, TX 77056-5331 | 2018-12-04 |
| 1538639638 | Clear Mind Agency LLC | General Practice | 1300 N Post Oak Rd, Houston, TX 77055-5431 | 2018-11-30 |
| 1346739158 | Abc Solutions Group Corp | General Practice | 10333 Harwin Dr Ste 530l, Houston, TX 77036-1545 | 2018-05-07 |
| 1073018768 | V & V Medical Management | General Practice | 13626 Veterans Memorial Dr Ste F, Houston, TX 77014 | 2018-03-26 |
| 1942703525 | Victor Yosef Melt Campos | General Practice | 1220 W Pierce St, Houston, TX 77019-4146 | 2018-03-09 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.