MEDICARE: WILLIAM ROBERSON 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	207Q00000X	Family Medicine Physician	L9873	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

General Provider Information

NPI Number	:	1750386413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ROBERSON DO

Provider Business Mailing Address
First Line	:	PO BOX 489
Second Line	:
City	:	MT ENTERPRISE
State	:	TX
Zip	:	75681-0489
Country	:	US
Telephone Number	:	903-392-8203
Fax Number	:	866-835-6516

Provider Business Practice Location Address
First Line	:	105 ZEID BLVD
Second Line	:
City	:	HENDERSON
State	:	TX
Zip	:	75652-6070
Country	:	US
Telephone Number	:	903-315-5615
Fax Number	:	903-657-1187

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	03/20/2023

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Directions to “ WILLIAM ROBERSON DO” Practice Location

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