Individual
MICHAEL T ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 539-9582
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-8372
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
363LA2100X
Acute Care Nurse Practitioner
Primary
30285
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1267409290
US ARMY
—
Enumeration date
02/25/2021
Last updated
11/17/2021
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