Individual
ROBERT O ROLLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3563 FAR WEST BLVD STE 110, AUSTIN, TX 78731-3029
(512) 846-6925
Mailing address
209 BAREFOOT PARK LN, GEORGETOWN, TX 78628-2148
(979) 219-1263
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
340027
LA
207P00000X
Emergency Medicine Physician
K2273
TX
207Q00000X
Family Medicine Physician
K2273
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137215313
—
TX
05
—
137215314
—
TX
05
—
171711802
—
TX
01
—
8P6794
BCBS
TX
01
—
8S2460
BCBS
TX
Enumeration date
06/09/2006
Last updated
02/14/2024
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