Individual
DR. ROBERT BURNHAM LAVERTY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(434) 258-1013
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-2460
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101268296
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/24/2018
Last updated
09/07/2021
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