Individual
TEENA JOSE ANTONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
154 GOVERNMENT CENTER DR, MOCKSVILLE, NC 27028-6299
(336) 753-6750
(336) 753-1272
Mailing address
1 BAYLOR PLZ # BCM320, HOUSTON, TX 77030-3411
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
202102334
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2018
Last updated
07/28/2021
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