MEDICARE: DR. JAMES G. 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	207L00000X	Anesthesiology Physician	L8174	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	87615	OTHER	NM	PRESBYTERIAN COMMERCIAL
2	8M0233	OTHER	TX	BC/BS
3	87766Z	OTHER	TX	HMO BLUE
4	139201100	OTHER	TX	FIRSTCARE COMMERCIAL
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	C004	OTHER		TRIWEST

General Provider Information

NPI Number	:	1861499261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES G. ROBERTS M.D.

Provider Business Mailing Address
First Line	:	808 MERION DR
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-3282
Country	:	US
Telephone Number	:	806-438-4550
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 LAMAR BLVD
Second Line	:	SUITE 400
City	:	ARLINGTON
State	:	TX
Zip	:	76006
Country	:	US
Telephone Number	:	682-227-6850
Fax Number	:

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	12/17/2012

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