MEDICARE: DR. PATRICIA LOIS ROBERTS D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	L1186	TX
2	207Q00000X	Family Medicine Physician	L1186	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053382846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA LOIS ROBERTS D.O.

Provider Business Mailing Address
First Line	:	2529 E. LANCASTER STE A
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76103-2232
Country	:	US
Telephone Number	:	817-534-7300
Fax Number	:	817-529-5031

Provider Business Practice Location Address
First Line	:	2529 E LANCASTER AVE STE A
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76103-2253
Country	:	US
Telephone Number	:	817-534-7300
Fax Number	:	817-529-5031

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	05/01/2026

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