Provider Demographics
NPI:1548232457
Name:PINO, SALUSTIANO ABABON (MD)
Entity Type:Individual
Prefix:DR
First Name:SALUSTIANO
Middle Name:ABABON
Last Name:PINO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:149 HART ST
Mailing Address - Street 2:82 MEDICAL GROUP
Mailing Address - City:SHEPPARD AFB
Mailing Address - State:TX
Mailing Address - Zip Code:76311-3477
Mailing Address - Country:US
Mailing Address - Phone:940-676-4472
Mailing Address - Fax:940-676-3730
Practice Address - Street 1:149 HART ST
Practice Address - Street 2:82 MEDICAL GROUP
Practice Address - City:SHEPPARD AFB
Practice Address - State:TX
Practice Address - Zip Code:76311-3477
Practice Address - Country:US
Practice Address - Phone:940-676-4472
Practice Address - Fax:940-676-3730
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF1196207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine