MEDICARE: DR. ANSELM JINGWA TINTINU MD

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	208600000X	Surgery Physician	E-13216	AR

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	:	1477878361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANSELM JINGWA TINTINU MD

Provider Business Mailing Address
First Line	:	2700 CITIZENS PLZ STE 403
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-5757
Country	:	US
Telephone Number	:	361-575-6396
Fax Number	:	361-578-5203

Provider Business Practice Location Address
First Line	:	2700 CITIZENS PLZ STE 403
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-5757
Country	:	US
Telephone Number	:	361-575-6396
Fax Number	:	361-578-5203

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

Provider Enumeration Date	:	04/02/2010
Last Update Date	:	01/08/2026

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