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NPI Code Detail

MEDICARE: DR. ROGER LOWELL MCROBERTS III MD

MEDICARE: DR. ROGER LOWELL MCROBERTS III MD
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
12084P0015XPsychosomatic Medicine PhysicianM6761TX

Other Identifiers

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

General Provider Information

NPI Number : 1053396564
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER LOWELL MCROBERTS III MD
Provider Business Mailing Address
First Line : 3501 MILLS AVE
Second Line : SETON SHOAL CREEK HOSPITAL
City : AUSTIN
State : TX
Zip : 78731-6309
Country : US
Telephone Number : 512-324-2080
Fax Number : 512-324-3379
Provider Business Practice Location Address
First Line : 3501 MILLS AVE
Second Line : SETON SHOAL CREEK HOSPITAL
City : AUSTIN
State : TX
Zip : 78731-6309
Country : US
Telephone Number : 512-324-2080
Fax Number : 512-324-3379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2005
Last Update Date : 01/17/2013

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