Healthcare Provider Details

I. General information

NPI: 1205000114
Provider Name (Legal Business Name): MICHAEL PALDINO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 W UNIVERSITY DR
PROSPER TX
75078-3123
US

IV. Provider business mailing address

PO BOX 733784
DALLAS TX
75373-3784
US

V. Phone/Fax

Practice location:
  • Phone: 682-885-6483
  • Fax: 682-303-7132
Mailing address:
  • Phone: 682-885-6483
  • Fax: 682-303-7132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number122366
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberP4222
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberMD466437
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: