Provider Demographics
NPI:1700021714
Name:PARDINO, SYDNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:
Last Name:PARDINO
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:PO BOX 226656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-6656
Mailing Address - Country:US
Mailing Address - Phone:214-943-9431
Mailing Address - Fax:
Practice Address - Street 1:1102 SOLON PLACE WAY STE 2
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165
Practice Address - Country:US
Practice Address - Phone:972-875-7488
Practice Address - Fax:972-875-7508
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR9263207X00000X
CAA116351207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA124334Medicare PIN