Healthcare Provider Details

I. General information

NPI: 1518229178
Provider Name (Legal Business Name): KELVIN DUANE ROBISON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 DENVER TRL
AZLE TX
76020-3614
US

IV. Provider business mailing address

107 RED OAK ST S
HUDSON OAKS TX
76087-7319
US

V. Phone/Fax

Practice location:
  • Phone: 817-820-4906
  • Fax: 817-820-4815
Mailing address:
  • Phone: 817-239-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD456556
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ8783
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: