Provider Demographics
NPI:1093768780
Name:SEGISMUNDO, ARTURO M (MD)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:M
Last Name:SEGISMUNDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10864 TEXAS HEALTH TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4897
Mailing Address - Country:US
Mailing Address - Phone:940-320-1708
Mailing Address - Fax:
Practice Address - Street 1:10864 TEXAS HEALTH TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4897
Practice Address - Country:US
Practice Address - Phone:940-320-1708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8327208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA42-1283849-46Medicaid
IA35387OtherWELLMARK BCBS IA
IA0415604Medicaid
IA1851101Medicaid
TX189512002Medicaid
IA1851101Medicaid
IA0415604Medicaid
IA35387OtherWELLMARK BCBS IA
TX8L16651Medicare PIN
H95830Medicare UPIN