Individual
JAMIE M ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701
(903) 531-4522
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP132911
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373487301
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
8269UP
BCBS
TX
01
—
P01811996
RAIL ROAD MEDICARE
TX
Enumeration date
01/03/2017
Last updated
06/26/2018
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