MEDICARE: MRS. TANA PETERSON ROBERTS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	N2759	TX

General Provider Information

NPI Number	:	1235346081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANA PETERSON ROBERTS M.D.

Provider Business Mailing Address
First Line	:	8350 N CENTRAL EXPY STE M1025
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1615
Country	:	US
Telephone Number	:	214-368-6341
Fax Number	:	214-368-5803

Provider Business Practice Location Address
First Line	:	8350 N CENTRAL EXPY STE M1025
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1615
Country	:	US
Telephone Number	:	214-368-6341
Fax Number	:	214-368-5803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	08/22/2025

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