Healthcare Provider Details

I. General information

NPI: 1922072479
Provider Name (Legal Business Name): ALAN E ROBBINS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 12TH AVE STE 104
FORT WORTH TX
76104-3926
US

IV. Provider business mailing address

1001 12TH AVE STE 104
FORT WORTH TX
76104-3926
US

V. Phone/Fax

Practice location:
  • Phone: 817-336-6600
  • Fax: 817-336-6503
Mailing address:
  • Phone: 817-336-6600
  • Fax: 817-336-6503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number855
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: