Individual
ROBERT LARRY ESWEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA., CSA., OPA-C
Contact information
Practice address
403 NW 7TH AVE, MINERAL WELLS, TX 76067-4201
(940) 452-1708
(940) 325-0199
Mailing address
PO BOX 1481, MINERAL WELLS, TX 76068-1481
(940) 452-1708
(940) 325-0199
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
363AS0400X
Surgical Physician Assistant
CERTIFICATE # 852
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
852
NATIONAL BOARD OF CERTIFICATION ORTHOPAEDIC PHYSICIAN ASSISTANTS (NBCOPA)
TX
01
—
NSAA 3369
NATIONAL SURGICAL ASSISTANTS ASSOCIATION
TX
01
—
SA00340
TEXAS MEDICAL BOAD
TX
Enumeration date
11/07/2006
Last updated
10/21/2009
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