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NPI Code Detail

MEDICARE: WILLIAM D'ANTONIO

MEDICARE: WILLIAM D'ANTONIO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician AssistantPA15734TX

General Provider Information

NPI Number : 1083204614
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM D'ANTONIO
Provider Business Mailing Address
First Line : 3003 NAVIGATION BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77003-1239
Country : US
Telephone Number : 713-223-4466
Fax Number : 713-223-1571
Provider Business Practice Location Address
First Line : 3003 NAVIGATION BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77003-1239
Country : US
Telephone Number : 713-223-4466
Fax Number : 713-223-1571
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2021
Last Update Date : 03/26/2024

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