Healthcare Provider Details

I. General information

NPI: 1861467904
Provider Name (Legal Business Name): MARK SCOTT ROBSON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 JAMES CASEY ST 3A
AUSTIN TX
78745-1120
US

IV. Provider business mailing address

4310 JAMES CASEY ST 3A
AUSTIN TX
78745-1120
US

V. Phone/Fax

Practice location:
  • Phone: 512-441-3668
  • Fax: 512-448-4460
Mailing address:
  • Phone: 512-441-3668
  • Fax: 512-448-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDPM1257
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: