Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | L1443 | TX |
NPI | 1033194592 |
---|---|
Provider Name | Dr. Glenn Robinson |
First Address | Austin, TX 78766-1597 |
Second Address | Austin, TX 78759-5264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 14/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E46893 | (02) | TX |