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General NPI Number Information
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NPI Number | 1689128456
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Entity Type | Individual
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Provider Name | MINA ANTOUN
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Gender | Male
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 2522 YALE ST STE 210
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City | HOUSTON
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State | TX
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Zip | 77008-2149
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Country | US
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Telephone | 832-409-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 12919 FIGARO DR
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City | HOUSTON
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State | TX
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Zip | 77024-4750
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Country | US
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Telephone | 914-334-9041
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 32321
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License Number State | TX
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