Provider Demographics
NPI:1902952351
Name:REMON FINO, MD, PA
Entity Type:Organization
Organization Name:REMON FINO, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REMON
Authorized Official - Middle Name:ANDONI
Authorized Official - Last Name:FINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-693-8263
Mailing Address - Street 1:3850 SAGEBRIAR DRIVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3483
Mailing Address - Country:US
Mailing Address - Phone:979-693-8263
Mailing Address - Fax:855-200-2521
Practice Address - Street 1:3850 SAGEBRIAR DRIVE
Practice Address - Street 2:SUITE 111
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3483
Practice Address - Country:US
Practice Address - Phone:979-693-8263
Practice Address - Fax:855-200-2521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7778225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175157001Medicaid
TX8S3400OtherBLUECHOICE SOLUTIONS ID
TX0094MQOtherBCBS ID #
TX047222702Medicaid
TX047222702Medicaid
TX0094MQOtherBCBS ID #
TX00044ZMedicare ID - Type UnspecifiedMEDICARE GROUP #
TXG47681Medicare UPIN
TXP00262548Medicare PIN