Provider Demographics
NPI:1700808391
Name:FINO, SAMEER ANDONI (MD)
Entity Type:Individual
Prefix:MR
First Name:SAMEER
Middle Name:ANDONI
Last Name:FINO
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 1:1316 PRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-5100
Mailing Address - Country:US
Mailing Address - Phone:972-288-9633
Mailing Address - Fax:972-288-9699
Practice Address - Street 1:1050 N BELT LINE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1782
Practice Address - Country:US
Practice Address - Phone:972-288-9633
Practice Address - Fax:972-288-9699
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2004208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88370KMedicare PIN
F41859Medicare UPIN