Provider Demographics
NPI:1659573145
Name:DONALD R. NINO. MDPA
Entity Type:Organization
Organization Name:DONALD R. NINO. MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:NINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-452-4747
Mailing Address - Street 1:15055 EAST FWY STE A10
Mailing Address - Street 2:
Mailing Address - City:CHANNELVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77530-4140
Mailing Address - Country:US
Mailing Address - Phone:281-452-4747
Mailing Address - Fax:281-457-2762
Practice Address - Street 1:15055 EAST FWY STE A10
Practice Address - Street 2:
Practice Address - City:CHANNELVIEW
Practice Address - State:TX
Practice Address - Zip Code:77530-4140
Practice Address - Country:US
Practice Address - Phone:281-452-4747
Practice Address - Fax:281-457-2762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty