Individual
DWAYNE LEE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 SUMMIT AVE, FORT WORTH, TX 76102-4427
(817) 332-2020
(817) 332-4797
Mailing address
1201 SUMMIT AVE, FORT WORTH, TX 76102-4427
(817) 332-2020
(817) 332-4797
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L8921
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166464101
—
TX
05
—
166464102
—
TX
01
—
8J0403
BCBS
TX
Enumeration date
06/24/2005
Last updated
05/13/2014
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