=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801105457
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TIM ROBINS M.D.,P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2010
-----------------------------------------------------
Last Update Date | 05/21/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7200 WYOMING SPRGS DR STE 1600
-----------------------------------------------------
City | ROUND ROCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78681-4703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-244-3554
-----------------------------------------------------
Fax | 512-244-2942
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7200 WYOMING SPRGS DR STE 1600
-----------------------------------------------------
City | ROUND ROCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78681-4703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-244-1615
-----------------------------------------------------
Fax | 512-244-2309
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TIM ROBINS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 512-244-1615
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | H2731
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------