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NPI Code Detail

MEDICARE: ROBERT DALE ANDERSON MD

MEDICARE:   ROBERT DALE ANDERSON  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
1207RC0000XCardiovascular Disease PhysicianH2211TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00246112OTHERTXRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
385V815OTHERTXBLUE CROSS

General Provider Information

NPI Number : 1063409001
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT DALE ANDERSON MD
Provider Business Mailing Address
First Line : 1300 W TERRELL AVE
Second Line : #500
City : FORT WORTH
State : TX
Zip : 76104-2800
Country : US
Telephone Number : 817-252-5000
Fax Number : 817-252-5060
Provider Business Practice Location Address
First Line : 1300 W TERRELL AVE
Second Line : #500
City : FORT WORTH
State : TX
Zip : 76104-2800
Country : US
Telephone Number : 817-252-5000
Fax Number : 817-252-5060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 04/09/2008

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Directions to “ ROBERT DALE ANDERSON MD” Practice Location

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