Provider Demographics
NPI:1023163326
Name:HARRIS COUNTY PUBLIC HEALTH & ENVIRONMENTAL SERVICES - ANTOINE CLINIC
Entity type:Organization
Organization Name:HARRIS COUNTY PUBLIC HEALTH & ENVIRONMENTAL SERVICES - ANTOINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:UMAIR
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:713-439-6184
Mailing Address - Street 1:5815 ANTOINE DR.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091
Mailing Address - Country:US
Mailing Address - Phone:281-447-2800
Mailing Address - Fax:
Practice Address - Street 1:5815 ANTOINE DR.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091
Practice Address - Country:US
Practice Address - Phone:713-602-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRIS COUNTY PUBLIC HEALTH & ENVIRONMENTAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-24
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018970601Medicaid
TX065190301Medicaid
TX029226001Medicaid
TX017628101Medicaid