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NPI Code Detail

MEDICARE: DR. NISHAAL ANTONY M.D.

MEDICARE: DR. NISHAAL ANTONY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease PhysicianS1753TX

General Provider Information

NPI Number : 1063824050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NISHAAL ANTONY M.D.
Provider Business Mailing Address
First Line : 4300 BOY SCOUT LN
Second Line :
City : EL PASO
State : TX
Zip : 79922-2201
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1205 N OREGON ST
Second Line :
City : EL PASO
State : TX
Zip : 79902-4023
Country : US
Telephone Number : 915-533-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2014
Last Update Date : 08/02/2019

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