Healthcare Provider Details

I. General information

NPI: 1699073114
Provider Name (Legal Business Name): ROBERT SCOTT HILBORN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 NW 24TH ST STE 208
FT WORTH TX
76164-8577
US

IV. Provider business mailing address

112 NW 24TH ST STE 208
FORT WORTH TX
76164-8577
US

V. Phone/Fax

Practice location:
  • Phone: 469-835-4301
  • Fax: 469-574-3711
Mailing address:
  • Phone: 469-835-4301
  • Fax: 469-574-3711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number34774
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number34774
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: