Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | M3861 | TX |
Y | 208600000X | Surgeon | M3861 | TX |
N | 2086S0105X | Surgery of the Hand | M3861 | TX |
NPI | 1639260128 |
---|---|
Provider Name | Dr. Robert Stanley Antonetti |
First Address | Plano, TX 75093-4640 |
Second Address | Plano, TX 75093-4640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
209902001 | (05) | TX |