Provider Demographics
NPI:1851384952
Name:NINO, DONALD R (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:R
Last Name:NINO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15055 EAST FWY
Mailing Address - Street 2:SUITE A-10
Mailing Address - City:CHANNELVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77530-4144
Mailing Address - Country:US
Mailing Address - Phone:281-452-4747
Mailing Address - Fax:281-457-2762
Practice Address - Street 1:15055 EAST FWY
Practice Address - Street 2:SUITE A-10
Practice Address - City:CHANNELVIEW
Practice Address - State:TX
Practice Address - Zip Code:77530-4144
Practice Address - Country:US
Practice Address - Phone:281-452-4747
Practice Address - Fax:281-457-2762
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2022-01-18
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Provider Licenses
StateLicense IDTaxonomies
TXG5432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00QE88OtherBC
TX0354425-02Medicaid
TX1696429-01Medicaid
TXP00122040OtherMC RR INDIV
TXDB6917OtherMC RR GROUP
TX00379WMedicare ID - Type UnspecifiedGROUP
TX1696429-01Medicaid
TXDB6917OtherMC RR GROUP