Basic Information
| Provider Information | |||||||||
| NPI: | 1982872453 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CELINSKI | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 911230 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753911230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729978000 | ||||||||
| FaxNumber: | 9722342987 | ||||||||
| Practice Location | |||||||||
| Address1: | 3410 WORTH ST STE 160 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752462092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2148269797 | ||||||||
| FaxNumber: | 2148262573 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2008 | ||||||||
| LastUpdateDate: | 05/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD433907 | PA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | MD036865 | DC | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | N6835 | TX | N | Allopathic & Osteopathic Physicians | Surgery | 2086X0206X | N6835 | TX | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 217331201 | 05 | TX | MEDICAID | 8CZ262 | 01 | TX | BCBSTX | OTHER | 217331206 | 05 | TX | MEDICAID | 8F8668 | 01 | TX | BCBSTX | OTHER | 217331202 | 05 | TX | MEDICAID |