Provider Demographics
NPI:1821003591
Name:AZZOLINI, SILVIO (MD)
Entity Type:Individual
Prefix:
First Name:SILVIO
Middle Name:
Last Name:AZZOLINI
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 1:222 W. LAS COLINAS BLVD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039
Mailing Address - Country:US
Mailing Address - Phone:972-657-3000
Mailing Address - Fax:972-236-0096
Practice Address - Street 1:701 S STEMMONS FWY
Practice Address - Street 2:SUITE 260
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4547
Practice Address - Country:US
Practice Address - Phone:972-316-6495
Practice Address - Fax:972-316-6500
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35745207Q00000X
TXM6509207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2206591-01Medicaid
TX2206591-01Medicaid