Provider Demographics
NPI:1386698538
Name:HANDLEY, ROBERT ARBUCKLE JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ARBUCKLE
Last Name:HANDLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 270865
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75027-0865
Mailing Address - Country:US
Mailing Address - Phone:972-410-5757
Mailing Address - Fax:972-410-5759
Practice Address - Street 1:4921 LONG PRAIRIE
Practice Address - Street 2:SUITE 110
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028
Practice Address - Country:US
Practice Address - Phone:972-410-5757
Practice Address - Fax:972-410-5759
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL0814202K00000X
OK248702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200078900AMedicaid
OK247625701Medicare PIN
OK200078900AMedicaid