Individual
DR. DONALD JACK ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3502 9TH ST, STE 260, LUBBOCK, TX 79415-3300
(806) 792-8185
(806) 792-9180
Mailing address
5219 CITY BANK PKWY, SUITE 135, LUBBOCK, TX 79407-3544
(806) 761-0334
(806) 782-0097
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
F7107
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000W0459
—
NM
01
—
122634100
FIRST CARE
—
01
—
131796804
CIDC
—
05
—
131796806
—
TX
01
—
299751
BLACK LUNG
—
01
—
780000444
RAIL ROAD MEDICARE
—
01
—
863277
BLUE CROSS BLUE SHIELD
—
01
—
A004
CHAMPUS
—
01
—
MDF7107
WORK COMP.
—
01
—
Y741
NM BLUE CROSS BLUE SHIELD
NM
Enumeration date
01/05/2007
Last updated
02/23/2017
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