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Individual

DR. HINA ILYAS ROBERTSON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
802 HOPKINS ST, GARLAND, TX 75040-7379
(214) 266-0700
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7582TG
TX
152WC0802X
Corneal and Contact Management Optometrist
7582TG
TX
152WP0200X
Pediatric Optometrist
7582TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287938901
TX
05
287938902
TX
01
83127Q
BCBS
TX
01
TXB107905
MEDICARE PTAN
TX
Enumeration date
07/09/2010
Last updated
11/21/2012
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