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General NPI Number Information
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NPI Number | 1508753112
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Entity Type | Individual
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Provider Name | TIFFANY ROBERTSON
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Gender | Female
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 101 AUSTIN BLVD # 1041
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City | RED OAK
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State | TX
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Zip | 75154-4666
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Country | US
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Telephone | 972-316-7448
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Fax | 972-316-7448
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Provider Business Mailing Address
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Address Line | 101 SWEET GUM ST
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City | RED OAK
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State | TX
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Zip | 75154-0140
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Country | US
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Telephone | 972-814-2009
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Fax | 972-814-2009
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 704531
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 704531
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License Number State | TX
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