# ILLUMINATE MEDICAL GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679036891
- **Authorized official:** DR. MATTHEW B ROBERSON MD (OWNER / CEO)
- **Authorized official phone:** (940) 220-9996

## Contact information

- **Practice address:** 1028 TRUMAN RD, LANTANA, TX 76226-4395
- **Practice address phone:** (940) 220-9996
- **Mailing address:** 1028 TRUMAN RD, LANTANA, TX 76226-4395
- **Mailing address phone:** (940) 220-9996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/14/2019
- **Last updated:** 02/20/2026