Provider Demographics
NPI:1306928742
Name:MCPHERSON, ROBERT E (PA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:7005 MIRA LOMA LN 102
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1411
Mailing Address - Country:US
Mailing Address - Phone:512-795-4344
Mailing Address - Fax:512-928-9466
Practice Address - Street 1:4314 YOAKUM BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5818
Practice Address - Country:US
Practice Address - Phone:713-850-0049
Practice Address - Fax:713-627-7302
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2015-09-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03368363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00477893OtherRR MCR
TX198128401Medicaid
TX8BC852OtherBCBS TX
TX8K4758Medicare PIN