Provider Demographics
NPI:1881020220
Name:ANTOINE CLINIC P.A.
Entity Type:Organization
Organization Name:ANTOINE CLINIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GURNAIB
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-664-0093
Mailing Address - Street 1:21212 NORTHWEST FWY
Mailing Address - Street 2:STE 335
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5884
Mailing Address - Country:US
Mailing Address - Phone:281-664-0093
Mailing Address - Fax:832-456-9875
Practice Address - Street 1:21212 NORTHWEST FWY
Practice Address - Street 2:STE 335
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5884
Practice Address - Country:US
Practice Address - Phone:281-664-0093
Practice Address - Fax:832-456-9875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7671207R00000X
TXF27622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty