MEDICARE: TIM PAUL RATINO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	P6705	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01220759	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154574044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIM PAUL RATINO M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 961205
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76161-1205
Country	:	US
Telephone Number	:	817-740-8400
Fax Number	:	817-332-6015

Provider Business Practice Location Address
First Line	:	1307 8TH AVE STE 506
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4142
Country	:	US
Telephone Number	:	817-332-6092
Fax Number	:	817-332-6015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2008
Last Update Date	:	01/27/2014

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Directions to “ TIM PAUL RATINO M.D.” Practice Location

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