Individual
DR. ANTHONY MICHAEL DEEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
414 NAVARRO ST, STE 809, SAN ANTONIO, TX 78205-2516
(210) 225-4810
(855) 392-7989
Mailing address
1045 CENTRAL PKWY N, SUITE 200, SAN ANTONIO, TX 78232-5085
(210) 536-9591
(904) 425-2949
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K9254
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046371306
—
TX
01
—
K9254
TEXAS LICENSE NUMBER
TX
01
—
P01665575
RR MEDICARE
TX
Enumeration date
06/13/2006
Last updated
11/18/2016
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