Individual
DR. ALFONSO E. PINO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11910 GREENVILLE AVENUE, SUITE 650, DALLAS, TX 75243-3596
(214) 373-9092
(214) 373-9250
Mailing address
P.O. BOX 741475, DALLAS, TX 75374-1475
(214) 373-9092
(214) 373-9250
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J4441
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100346901
—
TX
01
—
50051739
RAILROAD MEDICARE
TX
01
—
5125471
AETNA
TX
01
—
82130F
BLUE CROSS BLUE SHIELD TX
TX
01
—
97384
AMERIGROUP
TX
Enumeration date
05/16/2006
Last updated
07/10/2009
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