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NPI 1851384952

NPI 1851384952 : DONALD R NINO MD : CHANNELVIEW, TX

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General NPI Number Information
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    NPI Number           |    1851384952
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    Entity Type          |    Individual 
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    Provider Name        |    DONALD R NINO MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/24/2005
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    Last Update Date     |    01/18/2022
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Provider Practice Location Address
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    Address Line         |    15055 EAST FWY SUITE A-10
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    City                 |    CHANNELVIEW
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    State                |    TX
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    Zip                  |    77530-4144
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    Country              |    US
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    Telephone            |    281-452-4747
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    Fax                  |    281-457-2762
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Provider Business Mailing Address
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    Address Line         |    15055 EAST FWY SUITE A-10
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    City                 |    CHANNELVIEW
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    State                |    TX
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    Zip                  |    77530-4144
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    Country              |    US
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    Telephone            |    281-452-4747
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    Fax                  |    281-457-2762
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    G5432
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    License Number State |    TX
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