Individual
DR. ROBERT ARTHUR O'MAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(800) 257-8715
(800) 819-1655
Mailing address
541 COUNTY ROAD 1510, JACKSONVILLE, TX 75766-6777
(903) 589-0439
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
25797
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680010254
RAIL ROAD
TX
05
—
680010254
—
TX
01
—
86210A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/05/2006
Last updated
02/24/2010
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