Individual
ROBERT DOUGLAS WALKUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7117 HIGHWAY 84, SHALLOWATER, TX 79363-3761
(806) 441-7445
Mailing address
7117 HIGHWAY 84, SHALLOWATER, TX 79363-3761
(806) 441-7445
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0054607
CO
207P00000X
Emergency Medicine Physician
L3177
TX
207Q00000X
Family Medicine Physician
L3177
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0050KH
BLUE CROSS BLUE SHIELD
TX
01
—
101361100
FIRSTCARE LHC
TX
01
—
101361103
FIRSTCARE INDIVIDUAL
TX
05
—
149910509
—
TX
Enumeration date
05/01/2006
Last updated
08/22/2016
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