MEDICARE: DR. LACY DENAE ROBINSON

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	231H00000X	Audiologist	80228	TX
2	237600000X	Audiologist-Hearing Aid Fitter	80228	TX

General Provider Information

NPI Number	:	1710291513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LACY DENAE ROBINSON

Provider Business Mailing Address
First Line	:	8515 SPRING CYPRESS RD
Second Line	:	SUITE 105
City	:	SPRING
State	:	TX
Zip	:	77379-3354
Country	:	US
Telephone Number	:	281-444-9800
Fax Number	:	281-444-9801

Provider Business Practice Location Address
First Line	:	8515 SPRING CYPRESS RD
Second Line	:	SUITE 105
City	:	SPRING
State	:	TX
Zip	:	77379-3354
Country	:	US
Telephone Number	:	281-444-9800
Fax Number	:	281-444-9801

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

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	08/06/2010

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