PETROS KONOFAOS M.D. PHD NPI 1720364367

NPI Information

NPI: 1720364367
Provider Name: PETROS KONOFAOS, M.D., PHD
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

PECOS Registration: Yes

Address:
1005 HARBORSIDE DR
5TH FLOOR
GALVESTON, TX
ZIP 77555
Phone: (409) 772-8115
Get Directions

Petros Konofaos, M.D., PHD is a plastic and reconstructive surgery surgery in Galveston, TX with 26 years of experience. The provider is a surgeon who specializes in plastic and reconstructive surgery. Petros Konofaos, M.D., PHD NPI is 1720364367. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1005 HARBORSIDE DR
5TH FLOOR
GALVESTON, TX
ZIP 77555-001
Phone: (409) 772-8115
Fax: (409) 772-1872

The NPI 1720364367 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/27/2011 and was last updated on 5/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208200000X	Plastic Surgery		U1064	TEXAS	No
2	208200000X	Plastic Surgery		MD50989	TENNESSEE	No
3	208600000X	Surgery		U1064	TEXAS	No
4	2086S0122X	Surgery	Plastic and Reconstructive Surgery	U1064	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	08231501	MEDICAID	MISSISSIPPI
2	003180136A	MEDICAID	GEORGIA
3	Q007443	MEDICAID	TENNESSEE
4	1720364367	MEDICAID	MISSOURI
5	177445	MEDICAID	ALABAMA
6	204025001	MEDICAID	ARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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