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Individual

SAM SWINFORD ROBERTS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1201 W 38TH ST, AUSTIN, TX 78705-1006
(512) 324-1010
Mailing address
3106 RIVA RIDGE RD, AUSTIN, TX 78746-1815

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
F1940
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139425609
TX
05
139425612
TX
05
139425614
TX
05
139425624
TX
05
139425625
TX
05
139425626
TX
05
139425627
TX
05
139425629
TX
05
139425631
TX
05
139425638
TX
05
139425639
TX
05
139425640
TX
05
139425641
TX
Enumeration date
05/16/2006
Last updated
09/09/2009
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