Provider Demographics
NPI:1154339380
Name:ASISTIDO, ANTHONY FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:FRANCIS
Last Name:ASISTIDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 ELIZABETH ST
Mailing Address - Street 2:STE. 702
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2220
Mailing Address - Country:US
Mailing Address - Phone:361-883-4803
Mailing Address - Fax:361-883-4804
Practice Address - Street 1:613 ELIZABETH ST
Practice Address - Street 2:STE. 702
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2220
Practice Address - Country:US
Practice Address - Phone:361-883-4803
Practice Address - Fax:361-883-4804
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173000000X
TXK6530207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No173000000XOther Service ProvidersLegal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG9308Medicare UPIN
TX8K3035Medicare PIN
TX8432J8Medicare ID - Type Unspecified