Provider Demographics
NPI:1033289210
Name:EDUARDO P LENTINO MD PA
Entity Type:Organization
Organization Name:EDUARDO P LENTINO MD PA
Other - Org Name:EDUARDO P LENTINO MD FACS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:PEDRO
Authorized Official - Last Name:LENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-973-0812
Mailing Address - Street 1:8045 ANTOINE
Mailing Address - Street 2:226
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8345 LONG POINT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055
Practice Address - Country:US
Practice Address - Phone:713-973-0812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7649208D00000X
NY107298208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C18323Medicare UPIN
N54U0Medicare ID - Type Unspecified