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General NPI Number Information
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NPI Number | 1649567595
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Entity Type | Individual
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Provider Name | MEGAN THERESA ROBL M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 14856 PRESTON RD
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City | DALLAS
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State | TX
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Zip | 75254-6822
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Country | US
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Telephone | 816-509-9186
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Fax |
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Provider Business Mailing Address
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Address Line | 14856 PRESTON RD
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City | DALLAS
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State | TX
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Zip | 75254-6822
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Country | US
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Telephone | 816-509-9186
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 43011098896
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | Q2701
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 30519
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 60715
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS040747
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2013-01019
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License Number State | NC
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