Individual
CONDRED W ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3201 W HIGHWAY 22, CORSICANA, TX 75110
(903) 654-6812
Mailing address
P.O. BOX 1836, CORSICANA, TX 75110
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
220314
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023418-03
—
TX
05
—
002341804
—
TX
01
—
88170U
BCBS
TX
Enumeration date
06/16/2006
Last updated
03/23/2009
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