MEDICARE: DR ROBERT STROUD, P.A.

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	208800000X	Urology Physician	G5662	TX

General Provider Information

NPI Number	:	1649542168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR ROBERT STROUD, P.A.

Provider Business Mailing Address
First Line	:	1107 UNIVERSITY DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-3012
Country	:	US
Telephone Number	:	817-335-0199
Fax Number	:	817-612-6966

Provider Business Practice Location Address
First Line	:	1107 UNIVERSITY DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-3012
Country	:	US
Telephone Number	:	817-335-0199
Fax Number	:	817-612-6966

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT STROUD
Credential	:	D.O.
Telephone Number	:	817-800-5495

Provider Enumeration Date	:	01/30/2012
Last Update Date	:	04/21/2022

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