Provider Demographics
NPI:1104017185
Name:SAMEER FINO MD
Entity Type:Organization
Organization Name:SAMEER FINO MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMEER
Authorized Official - Middle Name:ANDONI
Authorized Official - Last Name:FINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-692-9300
Mailing Address - Street 1:1316 PRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-5100
Mailing Address - Country:US
Mailing Address - Phone:214-692-9300
Mailing Address - Fax:214-692-9305
Practice Address - Street 1:14721 COIT RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-8119
Practice Address - Country:US
Practice Address - Phone:214-692-9300
Practice Address - Fax:214-692-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2004174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099906202Medicaid
TX6476390001Medicare NSC
TX88370KMedicare PIN
00576KMedicare UPIN