Provider Demographics
NPI:1982872453
Name:CELINSKI, SCOTT ALAN (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALAN
Last Name:CELINSKI
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:3410 WORTH ST STE 160
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2092
Practice Address - Country:US
Practice Address - Phone:214-826-9797
Practice Address - Fax:214-826-2573
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433907208600000X
DCMD036865208600000X
TXN6835208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217331201Medicaid
TX8CZ262OtherBCBSTX
TX217331206Medicaid
TX8F8668OtherBCBSTX
TX217331202Medicaid
TXP01157092Medicare PIN
TX8F8668OtherBCBSTX
TX346840YNJCMedicare PIN
TXTXB138533Medicare PIN