Provider Demographics
NPI:1033401252
Name:WARD, ROBYN LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:LYNN
Last Name:WARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009-3716
Mailing Address - Country:US
Mailing Address - Phone:817-502-3451
Mailing Address - Fax:888-571-4035
Practice Address - Street 1:206 N PARKWAY DR
Practice Address - Street 2:
Practice Address - City:ALVARADO
Practice Address - State:TX
Practice Address - Zip Code:76009-3716
Practice Address - Country:US
Practice Address - Phone:817-502-3451
Practice Address - Fax:888-571-4035
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05854363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280871905Medicaid
TXTXB143161Medicare PIN
TXTXB124058Medicare PIN
TX280871901Medicaid
TX280871902Medicaid
TXTXB124059Medicare PIN