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General NPI Number Information
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NPI Number | 1780465443
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Entity Type | Individual
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Provider Name | ROYCE FITZGERALD ROBINSON MACC, BTH
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Gender | Male
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 17507 SALT RIVER VALLEY CIR
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City | HUMBLE
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State | TX
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Zip | 77346-2961
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Country | US
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Telephone | 281-962-8346
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Fax | 832-644-8496
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Provider Business Mailing Address
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Address Line | 17507 SALT RIVER VALLEY CIR
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City | HUMBLE
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State | TX
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Zip | 77346-2961
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Country | US
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Telephone | 281-962-8346
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Fax | 832-644-8496
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | TX
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