Healthcare Provider Details

I. General information

NPI: 1245207752
Provider Name (Legal Business Name): KAREN L ROBERTS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 HOLLYBROOK DR
LONGVIEW TX
75605-2410
US

IV. Provider business mailing address

707 HOLLYBROOK DR
LONGVIEW TX
75605-2410
US

V. Phone/Fax

Practice location:
  • Phone: 903-757-6042
  • Fax: 903-232-8226
Mailing address:
  • Phone: 903-757-6042
  • Fax: 903-232-8226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberF4433
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: