Individual
ROBERT G ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 12TH AVE STE 100, FORT WORTH, TX 76104-2519
(817) 810-0770
(817) 820-0242
Mailing address
800 12TH AVE STE 100, FORT WORTH, TX 76104-2519
(817) 810-0770
(817) 820-0242
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
E4176
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240008036
RAILROAD MEDICARE
—
Enumeration date
07/14/2006
Last updated
10/13/2021
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