Provider Demographics
NPI:1194709949
Name:SANTINI, NOEL O (MD)
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:O
Last Name:SANTINI
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:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3320 LIVE OAK ST
Practice Address - Street 2:EAST DALLAS HEALTH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6109
Practice Address - Country:US
Practice Address - Phone:214-266-1000
Practice Address - Fax:214-266-1128
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6716207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139124504Medicaid
TX139124503Medicaid
TX139124506Medicaid
TX139124507Medicaid
TX139124511Medicaid
TX139124512Medicaid
TX139124513Medicaid
TX139124501Medicaid
TX139124510Medicaid
TX139124502Medicaid
TX139124508Medicaid
TX139124509Medicaid
TX86Z766OtherBLUE CROSS BLUE SHIELD
TX139124510Medicaid
TX86Z766OtherBLUE CROSS BLUE SHIELD