Active NPI
Christopher Kreag Poulos, M.D.
- Forensic Pathology Physician
- Dallas, TX
National Provider Identifier
1275673220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Pathology Physician
- License
- 01061116A
- Practice address
- 5230 Medical Center Dr
Dallas, TX 75235-7710 - Phone
- (214) 920-5900
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Pathology Physician | 207ZF0201X | 01061116A | IN | Primary |
Addresses
Primary practice location
5230 Medical Center Dr
Dallas, TX 75235-7710
Mailing address
5720 Forest Park Rd
Apt 3216
Dallas, TX 75235-6420
Phone (214) 366-2270
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01061116A | Other | IN | STATE LICENSE |
| 524557 | Other | TX | POSTGRAD TRAINING PERMIT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01061116A | IN | MD | Forensic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275673220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5720 FOREST PARK RD",
"address_2": "APT 3216",
"city": "DALLAS",
"state": "TX",
"postal_code": "752356420",
"telephone_number": "214-366-2270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5230 MEDICAL CENTER DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752357710",
"telephone_number": "214-920-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULOS",
"first_name": "CHRISTOPHER",
"middle_name": "KREAG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZF0201X",
"taxonomy_group": "",
"desc": "Pathology, Forensic Pathology",
"state": "IN",
"license": "01061116A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "01061116A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "POSTGRAD TRAINING PERMIT",
"identifier": "524557",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.