MEDICARE: REGINA V ROBERTSON

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	251E00000X	Home Health Agency	014635	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	014635	OTHER	TX	HOME HEALTH LICENSE

General Provider Information

NPI Number	:	1235549098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGINA V ROBERTSON

Provider Business Mailing Address
First Line	:	1121 BRIARCREST DR STE 102
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-2500
Country	:	US
Telephone Number	:	979-693-3208
Fax Number	:	979-314-9002

Provider Business Practice Location Address
First Line	:	1121 BRIARCREST DR STE 102
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77802-2500
Country	:	US
Telephone Number	:	979-693-3208
Fax Number	:	979-314-9002

Authorized Official
Title or Position	:	FOUNDER & CEO
Name	:	REGINA VILLANUEVA ROBERTSON
Credential	:
Telephone Number	:	979-693-3208

Provider Enumeration Date	:	05/02/2014
Last Update Date	:	06/23/2026

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Directions to “REGINA V ROBERTSON ” Practice Location

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