Provider Demographics
NPI:1023435575
Name:FADI C CONSTANTINE, M.D. P.A
Entity type:Organization
Organization Name:FADI C CONSTANTINE, M.D. P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:CONSTANTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-500-8685
Mailing Address - Street 1:8220 WALNUT HILL LN
Mailing Address - Street 2:SUITE 206
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4427
Mailing Address - Country:US
Mailing Address - Phone:214-739-5760
Mailing Address - Fax:
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 206
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-739-5760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-22
Last Update Date:2014-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7091208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty