Provider Demographics
NPI:1154347227
Name:ISRAEL, ROBERT WARREN JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WARREN
Last Name:ISRAEL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 500A
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2256
Mailing Address - Country:US
Mailing Address - Phone:972-251-4050
Mailing Address - Fax:972-251-4052
Practice Address - Street 1:2001 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 500A
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2222
Practice Address - Country:US
Practice Address - Phone:972-251-4050
Practice Address - Fax:972-251-4052
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6782207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85488XOtherBCBS
TX042035801Medicaid
D66611Medicare UPIN
TX042035801Medicaid
TX110198169Medicare PIN