Basic Information
| Provider Information | |||||||||
| NPI: | 1497953905 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANTONE | ||||||||
| FirstName: | NAVEED | ||||||||
| MiddleName: | GILL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 WALLER ST | ||||||||
| Address2: | ATTN: FINANCE, 5TH FLOOR | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787025240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5129789000 | ||||||||
| FaxNumber: | 5129789001 | ||||||||
| Practice Location | |||||||||
| Address1: | 2529 S 1ST ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787045466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5129724833 | ||||||||
| FaxNumber: | 5129724848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2007 | ||||||||
| LastUpdateDate: | 02/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | T-23111 | TX | Y | Dental Providers | Dentist |
No ID Information.