Provider Demographics
NPI:1023043924
Name:ALBERT, ANTOINE ROBERT
Entity Type:Individual
Prefix:DR
First Name:ANTOINE
Middle Name:ROBERT
Last Name:ALBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S COIT RD
Mailing Address - Street 2:STE 317
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5743
Mailing Address - Country:US
Mailing Address - Phone:972-437-9090
Mailing Address - Fax:972-234-6474
Practice Address - Street 1:101 S COIT RD
Practice Address - Street 2:STE 317
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5743
Practice Address - Country:US
Practice Address - Phone:972-437-9090
Practice Address - Fax:972-234-6474
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0932207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8A5090OtherBCBS
8F8341Medicare PIN
C12654Medicare UPIN