Basic Information
| Provider Information | |||||||||
| NPI: | 1235463399 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PIZZINO | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | GUY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CNIM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 N CENTRAL EXPY UNIT 2586 | ||||||||
| Address2: | |||||||||
| City: | MCKINNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750700139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037044621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 33518 HALEY RD # 1 | ||||||||
| Address2: | |||||||||
| City: | WALLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774845110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883442947 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2009 | ||||||||
| LastUpdateDate: | 03/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZS0410X | 1289 | TN | N | 246ZE0600X | 1289 | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic |
ID Information
| ID | Type | State | Issuer | Description | 1289 | 01 | ABRET CNIM | OTHER |