Demetris Allen Green MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

J4168 Issued in TX

Legal business name

DEMETRIS ALLEN GREEN MD

Practice address

10610 Fondren Rd
Ste 124
Houston, TX 77096-5422

Phone

(713) 981-5167

Fax

(713) 981-5553

NPI assigned

Jun 18, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Demetris Allen Green Sr., MD

Title

Physician

Phone

(713) 383-9003

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Demetris a Green Sr MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Demetris a. Green, Sr. MD PA

  • General Practice Physician
  • Houston, TX
  • NPI 1740678770
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1669609459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8299 CAMBRIDGE ST APT 1203",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770543141",
            "telephone_number": "713-383-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10610 FONDREN RD",
            "address_2": "STE 124",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770965422",
            "telephone_number": "713-981-5167",
            "fax_number": "713-981-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMETRIS ALLEN GREEN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "DEMETRIS",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "713-383-9003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "J4168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "613884700",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lashonder Shantell Demery I, LCDC
• Brandy N Demesme-Trosclair
• Demetrio Tagaropules M.D., P.a.
• Sophia Demetriou
• Demetris a. Green, Sr. MD PA
• Krystel Demeza, NP
• Demi'S Lavished Boutique LLC
• Nagi M Demian, D.D.S.
• Diane Louise Deming, FNP
• Laura Deming, APRN

• General Practice Physician in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.