Provider Demographics
NPI:1033396304
Name:VINIK-JONES, ROBIN NOKI JEAN (CST/CFA/KCSA/LSA)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:NOKI JEAN
Last Name:VINIK-JONES
Suffix:
Gender:F
Credentials:CST/CFA/KCSA/LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8653 FUNTIER CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-2838
Mailing Address - Country:US
Mailing Address - Phone:682-551-8025
Mailing Address - Fax:
Practice Address - Street 1:8653 FUNTIER CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-2838
Practice Address - Country:US
Practice Address - Phone:682-551-8025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00343246ZC0007X
KYSA190246ZC0007X
246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist