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General NPI Number Information
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NPI Number | 1649258971
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Entity Type | Individual
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Provider Name | ROBERT S MICHAELSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 7500 BARLITE BLVD. SUITE 107
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City | SAN ANTONIO
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State | TX
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Zip | 78224-1338
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Country | US
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Telephone | 210-921-3493
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Fax | 210-921-3533
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Provider Business Mailing Address
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Address Line | PO BOX 1716
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City | SAN ANTONIO
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State | TX
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Zip | 78296-1716
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Country | US
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Telephone | 210-558-6288
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Fax |
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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 | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 34-00-3980- M
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | N8691
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | N8691
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License Number State | TX
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