Individual
DR. WILLIAM JERRY ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2604 ST MICHAEL DR, STE 410, TEXARKANA, TX 75503-2378
(903) 614-5430
(903) 614-5464
Mailing address
919 HIDDEN RDG, 6TH FLOOR, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-0996
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
C5231
AR
207V00000X
Obstetrics & Gynecology Physician
Primary
G0817
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103412001
—
AR
05
—
124648002
—
TX
05
—
124648005
—
TX
01
—
54444
BCBS
AR
Enumeration date
04/04/2006
Last updated
01/02/2017
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