Provider Demographics
NPI:1992784631
Name:SALDINO, MICHAEL C (DPM, CPO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:SALDINO
Suffix:
Gender:M
Credentials:DPM, CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 RICHMOND MDWS
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-0067
Mailing Address - Country:US
Mailing Address - Phone:903-838-3668
Mailing Address - Fax:903-838-8094
Practice Address - Street 1:4104 RICHMOND MDWS
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-0067
Practice Address - Country:US
Practice Address - Phone:903-838-3668
Practice Address - Fax:903-838-8094
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1620213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR82520OtherBLUE CROSS BLUE SHIELD
TX8J5040OtherBLUE CROSS BLUE SHIELD
TXU93678Medicare UPIN
TX00501VMedicare PIN