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NPI Code Detail

MEDICARE: WILLIAM J ROBENOLT

MEDICARE: WILLIAM J ROBENOLT
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
1367500000XCertified Registered Nurse Anesthetist580095TX

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 : 1588778880
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM J ROBENOLT
Provider Business Mailing Address
First Line : PO BOX 21265
Second Line :
City : WACO
State : TX
Zip : 76702-1265
Country : US
Telephone Number : 254-741-1185
Fax Number : 254-741-1860
Provider Business Practice Location Address
First Line : 3000 HERRING AVE
Second Line :
City : WACO
State : TX
Zip : 76708-3239
Country : US
Telephone Number : 254-741-1185
Fax Number : 254-741-1249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 07/08/2007

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