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Individual

ANTOINE WASHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 E DAWSON ST, TRINITY MOTHER FRANCES HOSPITAL, TYLER, TX 75701-2036
(512) 814-0298
(512) 597-2713
Mailing address
PO BOX 2386, BRAZOS VALLEY PATHOLOGY, ROUND ROCK, TX 78664
(240) 481-1492
(512) 597-2713

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
40115
KY
207ZC0500X
Cytopathology Physician
N6093
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0101232047
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
N6093
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
213071801
TX
01
TXB101861
MEDICARE
TX
Enumeration date
01/19/2006
Last updated
10/31/2014
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