Provider Demographics
NPI:1063955433
Name:DENNIS J. ROBISON MD PLLC
Entity type:Organization
Organization Name:DENNIS J. ROBISON MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CELECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-651-0772
Mailing Address - Street 1:6130 W PARKER RD
Mailing Address - Street 2:STE 103
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7901
Mailing Address - Country:US
Mailing Address - Phone:972-403-0801
Mailing Address - Fax:
Practice Address - Street 1:6130 W PARKER RD
Practice Address - Street 2:STE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7901
Practice Address - Country:US
Practice Address - Phone:972-403-0801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6695208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty