Provider Demographics
NPI:1811004112
Name:CONSTANTINE, SAMI ELIAS (MD)
Entity Type:Individual
Prefix:MR
First Name:SAMI
Middle Name:ELIAS
Last Name:CONSTANTINE
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 1:901 N GALLOWAY AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-7418
Mailing Address - Country:US
Mailing Address - Phone:972-288-1084
Mailing Address - Fax:297-289-3374
Practice Address - Street 1:901 N GALLOWAY AVE STE 107
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-7418
Practice Address - Country:US
Practice Address - Phone:972-288-1084
Practice Address - Fax:297-289-3374
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0161207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097767003Medicaid
TX88561NOtherMEDICARE ID
TXB21961Medicare UPIN