Individual
ROBERT EDWIN BROCKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
490 US HIGHWAY 80 E STE 100, SUNNYVALE, TX 75182-9212
(972) 279-3500
(972) 279-3505
Mailing address
490 US HIGHWAY 80 E STE 100, SUNNYVALE, TX 75182-9212
(972) 279-3500
(972) 279-3505
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
G3182
TX
207RI0011X
Interventional Cardiology Physician
Primary
G3182
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060030959
MEDICARE RAILROAD
TX
01
—
060031535
MEDICARE RAILROAD
TX
05
—
129350801
—
TX
05
—
129350803
—
TX
05
—
129350804
—
TX
01
—
81G603
BCBS
TX
01
—
85C466
BCBS
TX
Enumeration date
09/16/2005
Last updated
01/09/2020
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