MEDICARE: MR. SAMI ELIAS CONSTANTINE 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	207V00000X	Obstetrics & Gynecology Physician	F0161	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	88561N	OTHER	TX	MEDICARE ID

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	:	1811004112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SAMI ELIAS CONSTANTINE M.D.

Provider Business Mailing Address
First Line	:	901 N GALLOWAY AVE STE 107
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75149-7418
Country	:	US
Telephone Number	:	972-288-1084
Fax Number	:	297-289-3374

Provider Business Practice Location Address
First Line	:	901 N GALLOWAY AVE STE 107
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75149-7418
Country	:	US
Telephone Number	:	972-288-1084
Fax Number	:	297-289-3374

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	06/19/2018

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Directions to “ MR. SAMI ELIAS CONSTANTINE M.D.” Practice Location

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