MEDICARE: DR. ROBERT PRIETO M.D.

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	207RH0003X	Hematology & Oncology Physician	M4453	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8AM432	OTHER	BLUE CROSS

General Provider Information

NPI Number	:	1942294608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT PRIETO M.D.

Provider Business Mailing Address
First Line	:	3605 EXECUTIVE DR
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76904-6884
Country	:	US
Telephone Number	:	325-949-9555
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000B TRANS MOUNTAIN RD STE B400
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79911-3600
Country	:	US
Telephone Number	:	159-215-8400
Fax Number	:	915-612-9251

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	06/19/2019

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Directions to “ DR. ROBERT PRIETO M.D.” Practice Location

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