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General NPI Number Information
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NPI Number | 1124077573
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Entity Type | Individual
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Provider Name | ROBERT IPPOLITO MD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 9 MEDICAL PKWY STE 102
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City | DALLAS
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State | TX
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Zip | 75234-7852
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Country | US
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Telephone | 214-553-3323
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Fax | 214-553-3308
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Provider Business Mailing Address
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Address Line | 9221 LBJ FWY SUITE 208
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City | DALLAS
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State | TX
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Zip | 75243-3455
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Country | US
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Telephone | 972-644-8577
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Fax | 972-644-8577
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | H9653
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License Number State | TX
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