Individual
DR. ROBERT DANIEL PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1828 E SOUTHEAST LOOP 323 STE 111, TYLER, TX 75701-8314
(903) 593-0987
(903) 592-3309
Mailing address
1828 E SOUTHEAST LOOP 323 STE 111, TYLER, TX 75701-8314
(903) 593-0987
(903) 592-3309
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1636
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156579802
—
TX
01
—
1636
LICENSE
TX
01
—
P00040744
MEDICARE RAILROAD
TX
Enumeration date
09/19/2005
Last updated
05/13/2024
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