Healthcare Provider Details

I. General information

NPI: 1871047738
Provider Name (Legal Business Name): ANTOINE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7337 MCHENRY ST
HOUSTON TX
77087-3632
US

IV. Provider business mailing address

7337 MCHENRY ST
HOUSTON TX
77087-3632
US

V. Phone/Fax

Practice location:
  • Phone: 713-644-4442
  • Fax: 713-644-8964
Mailing address:
  • Phone: 713-644-4442
  • Fax: 713-644-8964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberE9374
License Number StateTX

VIII. Authorized Official

Name: DR. RUBIN L MORTON
Title or Position: DIRECTOR
Credential: M.D
Phone: 713-694-4300