Healthcare Provider Details

I. General information

NPI: 1710348073
Provider Name (Legal Business Name): ROBERT FONNER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E RANDOL MILL RD
ARLINGTON TX
76011-5838
US

IV. Provider business mailing address

315 E RANDOL MILL RD
ARLINGTON TX
76011-5838
US

V. Phone/Fax

Practice location:
  • Phone: 817-277-8121
  • Fax: 817-277-8191
Mailing address:
  • Phone: 817-277-8121
  • Fax: 817-277-8191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number80720
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: