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General NPI Number Information
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NPI Number | 1932328986
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Entity Type | Organization
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Legal Business Name | ISLAND HEALTH CENTER, P.A.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4623 FORT CROCKETT BLVD
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City | GALVESTON
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State | TX
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Zip | 77551-5962
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Country | US
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Telephone | 409-762-7646
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Fax | 409-762-9223
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Provider Business Mailing Address
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Address Line | 4623 FORT CROCKETT BLVD
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City | GALVESTON
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State | TX
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Zip | 77551-5962
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Country | US
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Telephone | 409-762-7646
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | DR. LORI L ANTMAN
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Credential | D.C.
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Telephone | 409-762-7646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | K6521
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC4392
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License Number State | TX
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