Provider Demographics
NPI:1881860724
Name:PINTO, MAURICIO (MD)
Entity Type:Individual
Prefix:
First Name:MAURICIO
Middle Name:
Last Name:PINTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAURICIO
Other - Middle Name:EDUARDO
Other - Last Name:PINTO SOSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2400 ROUND ROCK AVE
Mailing Address - Street 2:ST. DAVID'S ROUND ROCK MEDICAL CENTER
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681
Mailing Address - Country:US
Mailing Address - Phone:956-607-0896
Mailing Address - Fax:512-341-5131
Practice Address - Street 1:2400 ROUND ROCK AVE
Practice Address - Street 2:ST. DAVID'S ROUND ROCK MEDICAL CENTER
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:956-607-0896
Practice Address - Fax:512-341-5131
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2012-0532207Q00000X, 208M00000X
AZ72729207Q00000X
TXP4799208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1881860724Medicare PIN