Provider Demographics
NPI:1861480204
Name:BOCCARDO-SABATINI, SILVIA (MD)
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:BOCCARDO-SABATINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 CRENSHAW ROAD
Mailing Address - Street 2:STE 100
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3139
Mailing Address - Country:US
Mailing Address - Phone:281-487-3840
Mailing Address - Fax:281-487-3861
Practice Address - Street 1:5050 CRENSHAW RD
Practice Address - Street 2:STE 100
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3139
Practice Address - Country:US
Practice Address - Phone:281-487-3840
Practice Address - Fax:281-487-3861
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1780207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045016503Medicaid
TX86850JMedicare ID - Type Unspecified
TXG38714Medicare UPIN