MEDICARE: TIMOTHY SCOT ROBERTSON DO

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	207P00000X	Emergency Medicine Physician	OS7832	FL
2	207P00000X	Emergency Medicine Physician	N3274	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	58716	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1720067432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY SCOT ROBERTSON DO

Provider Business Mailing Address
First Line	:	26 SPRING BASKET TRL
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77389-4991
Country	:	US
Telephone Number	:	702-525-0911
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 SPRING BASKET TRL
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77389
Country	:	US
Telephone Number	:	702-525-0911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	01/21/2016

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