Provider Demographics
NPI:1811288467
Name:ROBLES, JULIANA LORRAINE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIANA
Middle Name:LORRAINE
Last Name:ROBLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:210-922-7000
Mailing Address - Fax:210-457-3390
Practice Address - Street 1:5439 RAY ELLISON BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78242-2219
Practice Address - Country:US
Practice Address - Phone:210-922-7000
Practice Address - Fax:210-457-3390
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0164208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX334411101Medicaid
TX334411101Medicaid