Provider Demographics
NPI:1699157792
Name:DILLARD, ROBERT CARL III (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CARL
Last Name:DILLARD
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:22999 HWY 59 N STE B220
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-4460
Mailing Address - Country:US
Mailing Address - Phone:281-516-8184
Mailing Address - Fax:
Practice Address - Street 1:22999 HWY 59 N STE B220
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4460
Practice Address - Country:US
Practice Address - Phone:281-516-8184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT1343208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT1343OtherTEXAS BOARD OF MEDICINE
PAOS020594OtherPENNSYLVANIA OSTEOPATHIC BOARD OF MEDICINE