Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | S1753 | TX |
NPI | 1063824050 |
---|---|
Provider Name | Dr. Nishaal Antony |
First Address | El Paso, TX 79922-2201 |
Second Address | El Paso, TX 79902-4023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2014 |
Last Update Date | 02/08/2019 |