Provider Demographics
NPI:1528075801
Name:GREEN, ROBERT P JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:GREEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:414 NAVARRO ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2516
Mailing Address - Country:US
Mailing Address - Phone:210-223-5561
Mailing Address - Fax:210-223-5093
Practice Address - Street 1:414 NAVARRO ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2516
Practice Address - Country:US
Practice Address - Phone:210-223-5561
Practice Address - Fax:210-223-5093
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-02-19
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Provider Licenses
StateLicense IDTaxonomies
TXF1603207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF1603OtherPHYSICIAN PERMIT
TX124472502Medicaid
TX124472503Medicaid
TX829116Medicare ID - Type Unspecified
TXF1603OtherPHYSICIAN PERMIT
TX124472502Medicaid