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NPI Code Detail

MEDICARE: IMELDA ROBERTS RN

MEDICARE: IMELDA ROBERTS RN
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
1163W00000XRegistered Nurse825798TX

General Provider Information

NPI Number : 1699622902
Entity Type Code : Individual
Provider Name (Legal Business Name) : IMELDA ROBERTS RN
Provider Business Mailing Address
First Line : 1506 SHADY HILLSIDE PASS
Second Line :
City : ROUND ROCK
State : TX
Zip : 78665-3809
Country : US
Telephone Number : 844-279-3627
Fax Number :
Provider Business Practice Location Address
First Line : 425 UNIVERSITY BLVD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78665-1360
Country : US
Telephone Number : 844-279-3627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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