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General NPI Number Information
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NPI Number | 1013882992
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Entity Type | Organization
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Legal Business Name | ROBERSON CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 310 W RUSK ST
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City | TYLER
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State | TX
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Zip | 75701-1513
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Country | US
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Telephone | 903-515-5535
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7215
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City | TYLER
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State | TX
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Zip | 75711-7215
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Country | US
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Telephone | 903-515-5535
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER/OWNER/PRESIDENT
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Name | MATTHEW D ROBERSON
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Credential | DC
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Telephone | 903-515-5535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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