Provider Demographics
NPI:1912393901
Name:ADDOUMIEH, ANTOINE (MD)
Entity type:Individual
Prefix:
First Name:ANTOINE
Middle Name:
Last Name:ADDOUMIEH
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 1:5126 W LOOP 1604 N # 407
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4408
Mailing Address - Country:US
Mailing Address - Phone:210-281-9800
Mailing Address - Fax:210-281-1001
Practice Address - Street 1:5126 W LOOP 1604 N # 407
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4408
Practice Address - Country:US
Practice Address - Phone:210-281-9800
Practice Address - Fax:210-281-1001
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0686207RC0000X, 207R00000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine