Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | G2413 | TX |
NPI | 1104869544 |
---|---|
Provider Name | Dr. Robert Lewis Kirby |
First Address | Dallas, TX 75391-1230 |
Second Address | Plano, TX 75075-7753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 21/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8R1487 | BLUE CROSS OF TX (01) | TX |
C17917 | (02) |