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General NPI Number Information
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NPI Number | 1366730459
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Entity Type | Organization
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Legal Business Name | ROBERT IAN MYERS, MD, PA
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 3600 GASTON AVE SUITE 508
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City | DALLAS
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State | TX
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Zip | 75246-1805
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Country | US
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Telephone | 214-824-4585
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Fax | 214-824-0917
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Provider Business Mailing Address
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Address Line | 3600 GASTON AVE SUITE 508
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City | DALLAS
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State | TX
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Zip | 75246-1805
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Country | US
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Telephone | 214-824-4585
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Fax | 214-824-0917
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Authorized Official
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Title or Position | MANAGER
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Name | MS. LYNN SPARROW
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Credential |
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Telephone | 214-823-2373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G9170
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License Number State | TX
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