Provider Demographics
NPI:1699794834
Name:RODRICK D ROBINSON
Entity type:Organization
Organization Name:RODRICK D ROBINSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-283-2132
Mailing Address - Street 1:1402 S CUSTER RD STE 504
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1453
Mailing Address - Country:US
Mailing Address - Phone:972-233-5433
Mailing Address - Fax:972-233-5435
Practice Address - Street 1:1402 S CUSTER RD STE 504
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-233-5433
Practice Address - Fax:972-233-5435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187940502Medicaid
TX5841610001Medicare NSC