Provider Demographics
NPI:1154574044
Name:RATINO, TIM PAUL (MD)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:PAUL
Last Name:RATINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 961205
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76161-1205
Mailing Address - Country:US
Mailing Address - Phone:817-740-8400
Mailing Address - Fax:817-332-6015
Practice Address - Street 1:1307 8TH AVE STE 506
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4142
Practice Address - Country:US
Practice Address - Phone:817-332-6092
Practice Address - Fax:817-332-6015
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP6705208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX324482401Medicaid
TXP01220759OtherRAILROAD MEDICARE