Provider Demographics
NPI:1174725253
Name:BOUKAS, KONSTANTINOS (MD)
Entity type:Individual
Prefix:
First Name:KONSTANTINOS
Middle Name:
Last Name:BOUKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6431 FANNIN STREET
Mailing Address - Street 2:MSB 3.160
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-500-5652
Mailing Address - Fax:713-486-0989
Practice Address - Street 1:6431 FANNIN STREET
Practice Address - Street 2:MSB 3.160
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-500-5652
Practice Address - Fax:713-486-0989
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP9165208000000X, 2080P0203X
FLME 101777208000000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics