Provider Demographics
NPI:1053317297
Name:DURAN, ROBERT R (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:DURAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1340 WONDER WORLD DR
Mailing Address - Street 2:STE 4301
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7598
Mailing Address - Country:US
Mailing Address - Phone:512-353-6400
Mailing Address - Fax:512-353-6423
Practice Address - Street 1:1305 WONDER WORLD DR STE 209
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7541
Practice Address - Country:US
Practice Address - Phone:512-353-6400
Practice Address - Fax:512-353-3039
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3318208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01827417OtherRR MEDICARE
TX032802302Medicaid
TXB163371OtherMEDICARE
TXB87628Medicare UPIN