Provider Demographics
NPI:1518921139
Name:BIANCO, SABATINO (MD)
Entity Type:Individual
Prefix:
First Name:SABATINO
Middle Name:
Last Name:BIANCO
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 1:1001 N WALDROP DR
Mailing Address - Street 2:SUITE 403
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4705
Mailing Address - Country:US
Mailing Address - Phone:817-701-4253
Mailing Address - Fax:817-701-4258
Practice Address - Street 1:1001 N WALDROP DR
Practice Address - Street 2:SUITE 403
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4705
Practice Address - Country:US
Practice Address - Phone:817-701-4253
Practice Address - Fax:817-701-4258
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21890207T00000X
TXM6527207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752616977008OtherTRICARE
TX6362340001OtherMEDICARE PTAN
TX9411968OtherPHCS
TX143917OtherSUPERIOR HEALTH-CHIPS
TX189428901Medicaid
WV3810002713Medicaid
TX8AG190OtherBCBS OF TEXAS
TX189428901Medicaid
TX6362340001Medicare NSC
TX8K0770Medicare Oscar/Certification