Provider Demographics
NPI:1912188111
Name:BARTONICO, ANTONIO SABLAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:SABLAD
Last Name:BARTONICO
Suffix:
Gender:M
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:PO BOX 163085
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-3085
Mailing Address - Country:US
Mailing Address - Phone:936-436-2084
Mailing Address - Fax:
Practice Address - Street 1:100 W CENTRAL TEXAS EXPY STE 208
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2080
Practice Address - Country:US
Practice Address - Phone:254-681-3842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG08962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry