Individual
ROBERT WESLEY HATHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845-6440
(979) 207-4000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
A49051
CA
208800000X
Urology Physician
Primary
P0064
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BF148X
MEDICARE-PTAN
CA
Enumeration date
05/20/2006
Last updated
12/10/2021
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