Provider Demographics
NPI:1710475058
Name:GHABY, ANTOINE (DO)
Entity Type:Individual
Prefix:
First Name:ANTOINE
Middle Name:
Last Name:GHABY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:
Other - Last Name:GHABY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6569 SPY GLASS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-9390
Mailing Address - Country:US
Mailing Address - Phone:310-294-4648
Mailing Address - Fax:
Practice Address - Street 1:120 E HARRIS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5904
Practice Address - Country:US
Practice Address - Phone:325-653-6741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS9135207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine