Provider Demographics
NPI:1154435808
Name:TOMASINO, RODOLFO (MD)
Entity type:Individual
Prefix:
First Name:RODOLFO
Middle Name:
Last Name:TOMASINO
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 1:1201 E SCHUSTER AVE
Mailing Address - Street 2:STE 2A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4672
Mailing Address - Country:US
Mailing Address - Phone:915-533-2133
Mailing Address - Fax:915-533-2133
Practice Address - Street 1:1201 E SCHUSTER SUITE 2-A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2802
Practice Address - Country:US
Practice Address - Phone:915-533-5505
Practice Address - Fax:915-533-5505
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5966207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00AR72OtherBCBS
TX114028701Medicaid
D69192Medicare UPIN
TX114028701Medicaid