Provider Demographics
NPI:1528134517
Name:DEMANDANTE, CARLO GREG NIEPES (MD)
Entity type:Individual
Prefix:DR
First Name:CARLO GREG
Middle Name:NIEPES
Last Name:DEMANDANTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:70 GLENTRACE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-5607
Mailing Address - Country:US
Mailing Address - Phone:903-747-2480
Mailing Address - Fax:281-767-2634
Practice Address - Street 1:721 CLINIC DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2043
Practice Address - Country:US
Practice Address - Phone:903-595-5550
Practice Address - Fax:903-535-6330
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2024-03-24
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Provider Licenses
StateLicense IDTaxonomies
FLME1313312085R0001X
WAMD604132822085R0001X
AK1153682085R0001X
TXP95482085R0001X
TXFD42275592085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology