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General NPI Number Information
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NPI Number | 1447462932
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Entity Type | Organization
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Legal Business Name | RODNEY ROBERTSON OD PC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 1220 N TOWN EAST BLVD SUITE 220
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City | MESQUITE
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State | TX
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Zip | 75150-7605
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Country | US
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Telephone | 972-613-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 N TOWN EAST BLVD SUITE 220
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City | MESQUITE
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State | TX
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Zip | 75150-7605
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Country | US
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Telephone | 972-613-9000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RODNEY L ROBERTSON
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Credential | OD
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Telephone | 972-613-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3735TG
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License Number State | TX
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