Provider Demographics
NPI:1871882720
Name:CIMINO, SCOTT ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANTHONY
Last Name:CIMINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SPIRIT CT
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-1158
Mailing Address - Country:US
Mailing Address - Phone:817-709-5221
Mailing Address - Fax:
Practice Address - Street 1:5300 TOWN AND COUNTRY BLVD STE 260
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:817-709-5221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0896207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine