Provider Demographics
NPI:1952596801
Name:SAMI E. CONSTANTINE, M.D. ASSOCIATED
Entity Type:Organization
Organization Name:SAMI E. CONSTANTINE, M.D. ASSOCIATED
Other - Org Name:TEXAS REGIONAL WOMENS HEALTH CTR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONSTANTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-288-1084
Mailing Address - Street 1:901 N. GALLOWAY AVE.
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-7418
Mailing Address - Country:US
Mailing Address - Phone:972-288-1084
Mailing Address - Fax:972-289-3374
Practice Address - Street 1:901 N. GALLOWAY AVE.
Practice Address - Street 2:SUITE 107
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-7418
Practice Address - Country:US
Practice Address - Phone:972-288-1084
Practice Address - Fax:972-289-3374
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAMI E. CONSTANTINE, M.D. ASSOCIATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-12
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0161207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097767003Medicaid
B21961Medicare UPIN
TX097767003Medicaid