Provider Demographics
NPI:1992025944
Name:ROBALINO, VANESSA INES (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:INES
Last Name:ROBALINO
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5119 BIG MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4877
Mailing Address - Country:US
Mailing Address - Phone:281-646-0740
Mailing Address - Fax:281-646-0740
Practice Address - Street 1:21770 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2513
Practice Address - Country:US
Practice Address - Phone:281-646-0740
Practice Address - Fax:281-646-0740
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105245363AM0700X
TXPA16006363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical