Provider Demographics
NPI:1114168051
Name:CARDILE, ANTHONY PAUL II (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:PAUL
Last Name:CARDILE
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DRIVE
Mailing Address - Street 2:BROOKE ARMY MEDICAL CENTER
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-22
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIDOS 1329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000Medicare UPIN