Provider Demographics
NPI:1871681684
Name:SARACINO, DINO PETER (MD)
Entity Type:Individual
Prefix:
First Name:DINO
Middle Name:PETER
Last Name:SARACINO
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 1:1700 N OREGON ST
Mailing Address - Street 2:SUITE 620
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3584
Mailing Address - Country:US
Mailing Address - Phone:915-351-9000
Mailing Address - Fax:915-351-9041
Practice Address - Street 1:1700 N OREGON ST
Practice Address - Street 2:SUITE 620
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3584
Practice Address - Country:US
Practice Address - Phone:915-351-9000
Practice Address - Fax:915-351-9041
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0900208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM74670077Medicaid
TX55MPOtherBC/BS OF TEXAS
NM74670077Medicaid
TX611879Medicare ID - Type Unspecified