Provider Demographics
NPI:1750103537
Name:ISBELL, ANTIONE
Entity type:Individual
Prefix:MR
First Name:ANTIONE
Middle Name:
Last Name:ISBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 S DAIRY ASHFORD RD STE 207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-4759
Mailing Address - Country:US
Mailing Address - Phone:832-479-7994
Mailing Address - Fax:
Practice Address - Street 1:1880 S DAIRY ASHFORD RD STE 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4759
Practice Address - Country:US
Practice Address - Phone:832-479-7994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator