Individual
ROBERT RAY ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
3605 N.E. LOOP 286, SUITE 2000, PARIS, TX 75460-5085
(903) 782-9500
(903) 782-9550
Mailing address
PO BOX 6369, PARIS, TX 75461-6245
(903) 782-9500
(903) 782-9550
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
569790
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062572502
—
TX
01
—
75-2803871
TAX IDENTIFICATION NUMBER
TX
01
—
8Y8876
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/27/2006
Last updated
08/07/2014
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