# ROBERT D. KISTLER MD

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

## Provider details

- **NPI number:** 1932708351
- **Authorized official:** DR. ROBERT D KISTLER MD (MANAGER/OWNER)
- **Authorized official phone:** (936) 634-2231

## Contact information

- **Practice address:** 3804 S MEDFORD DR, LUFKIN, TX 75901-5780
- **Practice address phone:** (936) 634-2231
- **Practice address fax:** (936) 634-8012
- **Mailing address:** 3804 S MEDFORD DR, LUFKIN, TX 75901-5780
- **Mailing address phone:** (936) 634-2231
- **Mailing address fax:** (936) 634-8012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2020
- **Last updated:** 04/29/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | G8217 | LICENSE | TX |