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NPI Code Detail

MEDICARE: DANIELLE MARIE ROBERTSON OD

MEDICARE: DANIELLE MARIE ROBERTSON OD
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
1152W00000XOptometrist06250TTX

General Provider Information

NPI Number : 1902081565
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE MARIE ROBERTSON OD
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-5347
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5303 HARRY HINES BLVD FL 6
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-645-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2008
Last Update Date : 12/23/2025

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