MEDICARE: SAMI E. CONSTANTINE, M.D. ASSOCIATED

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

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	:	1952596801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMI E. CONSTANTINE, M.D. ASSOCIATED

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

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

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SAMI E. CONSTANTINE
Credential	:	M.D.
Telephone Number	:	972-288-1084

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	11/29/2018

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