Provider Demographics
NPI:1760785448
Name:LINTINI, PETER (SA-C)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:LINTINI
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14827 PRESTON RD
Mailing Address - Street 2:APT 1707
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-9102
Mailing Address - Country:US
Mailing Address - Phone:214-727-1370
Mailing Address - Fax:
Practice Address - Street 1:14827 PRESTON RD
Practice Address - Street 2:APT 1707
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-9102
Practice Address - Country:US
Practice Address - Phone:214-727-1370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10-291246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant