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NPI Code Detail

MEDICARE: DANA BROOKS ROBERSON CRNA

MEDICARE: DANA BROOKS ROBERSON CRNA
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 Anesthetist505356TX

Other Identifiers

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

General Provider Information

NPI Number : 1831160415
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA BROOKS ROBERSON CRNA
Provider Business Mailing Address
First Line : 1301 E DEBBIE LN
Second Line : SUITE 102-144
City : MANSFIELD
State : TX
Zip : 76063-3305
Country : US
Telephone Number : 817-233-8862
Fax Number : 866-842-4031
Provider Business Practice Location Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-648-7834
Fax Number : 214-645-0078
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 08/31/2012

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