Healthcare Provider Details

I. General information

NPI: 1518921139
Provider Name (Legal Business Name): SABATINO BIANCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 N WALDROP DR SUITE 403
ARLINGTON TX
76012-4705
US

IV. Provider business mailing address

1001 N WALDROP DR SUITE 403
ARLINGTON TX
76012-4705
US

V. Phone/Fax

Practice location:
  • Phone: 817-701-4253
  • Fax: 817-701-4258
Mailing address:
  • Phone: 817-701-4253
  • Fax: 817-701-4258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number21890
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberM6527
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: