Individual
DR. PHILIP BLANCO ANTIPORTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 PENNSYLVANIA AVE STE 350, FORT WORTH, TX 76104-2172
(817) 887-9389
(817) 887-9392
Mailing address
PO BOX 802772, DALLAS, TX 75380-2772
(972) 484-7700
(972) 484-7718
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
036.133199
IL
207RI0200X
Infectious Disease Physician
Primary
R8147
TX
Other
Enumeration date
07/25/2010
Last updated
03/10/2022
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