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Individual

DR. JERRY TED ROBERTS

Active
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Individual

DR. JERRY TED ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
TX2344TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019369001
—
TX
01
—
168830001
CIGNA GOVERNMENT
TX
01
—
410022897
PALMETTO GBA RAILROAD MED
TX
01
—
83381E
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/14/2006
Last updated
02/11/2008
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