Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | D0069803 | MD |
N | 207V00000X | Obstetrician & Gynecologist | MD038023 | DC |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | P1516 | TX |
NPI | 1578711495 |
---|---|
Provider Name | Dr. Danielle D. Antosh |
First Address | Houston, TX 77030-2761 |
Second Address | Houston, TX 77030-2761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 16/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
311135301 | (05) | TX |
8FT386 | BLUE CROSS BLUE SHIELD (01) | TX |
P01186461 | RR MEDICARE (01) | TX |