Individual
MARY K. ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
5201 HARRY HINES BLVD, MEDICAL AFFAIRS, DALLAS, TX 75235-7708
(214) 590-8006
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
(214) 590-4105
(214) 590-4162
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
519874
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8Y2002
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/14/2007
Last updated
10/22/2007
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