Provider Demographics
NPI:1710037940
Name:LOIZ BRONSTEIN, ANTONIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIA
Middle Name:
Last Name:LOIZ BRONSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 NORWOOD PLZ
Mailing Address - Street 2:SUITE A
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3748
Mailing Address - Country:US
Mailing Address - Phone:817-280-0016
Mailing Address - Fax:817-280-0622
Practice Address - Street 1:1832 NORWOOD PLZ
Practice Address - Street 2:SUITE A
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3748
Practice Address - Country:US
Practice Address - Phone:817-280-0016
Practice Address - Fax:817-280-0622
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXTXG7084208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G562OtherBCBS
TX10029823Medicaid
TX10029823Medicaid
TX10029823Medicaid
TX10029823Medicaid