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NPI Code Detail

MEDICARE: ROBERT COREY BOES MSW, LCSW

MEDICARE: ROBERT COREY BOES MSW, LCSW
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
11041C0700XClinical Social Worker253892KY
21041C0700XClinical Social Worker103941TX

General Provider Information

NPI Number : 1558827949
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT COREY BOES MSW, LCSW
Provider Business Mailing Address
First Line : 905 W CANTEY ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-3205
Country : US
Telephone Number : 817-382-1876
Fax Number :
Provider Business Practice Location Address
First Line : 905 W CANTEY ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-3205
Country : US
Telephone Number : 817-382-1876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2019
Last Update Date : 07/02/2025

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