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General NPI Number Information
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NPI Number | 1104004357
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Entity Type | Organization
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Legal Business Name | LYNNE J. ROBERTS, M.D., P. A.
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 7502 GREENVILLE AVE SUITE 330
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City | DALLAS
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State | TX
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Zip | 75231-3832
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Country | US
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Telephone | 469-232-9300
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Fax | 469-232-9850
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Provider Business Mailing Address
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Address Line | 7502 GREENVILLE AVE SUITE 330
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City | DALLAS
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State | TX
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Zip | 75231-3832
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Country | US
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Telephone | 469-232-9300
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Fax | 469-232-9850
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LYNNE J. ROBERTS
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Credential | M.D.
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Telephone | 469-232-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | F8647
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License Number State | TX
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