Individual
DR. SIDNEY CREED ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 W FRANK AVE, LUFKIN, TX 75904-3357
(936) 639-7466
(936) 639-7472
Mailing address
PO BOX 95350, GRAPEVINE, TX 76099-9733
(877) 839-9517
(903) 531-2337
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
H4653
TX
2085R0203X
Therapeutic Radiology Physician
Primary
H4653
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110403601
—
TX
01
—
85R980
BCBS OF TEXAS
TX
Enumeration date
05/24/2006
Last updated
02/25/2022
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