Individual
DR. JERRY TED ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1100 STONE RD, SUITE 2020, KILGORE, TX 75662-5482
(903) 983-2020
(903) 983-4000
Mailing address
1100 STONE RD, SUITE 2020, KILGORE, TX 75662-5482
(903) 983-2020
(903) 983-4000
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
TX2344TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019369001
—
TX
01
—
168830001
CIGNA GOVERNMENT
TX
01
—
410022897
PALMETTO GBA RAILROAD MED
TX
01
—
83381E
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/14/2006
Last updated
02/11/2008
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