Provider Demographics
NPI:1114380185
Name:COHEN, MICHAEL ROBERTSON (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ROBERTSON
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 CENTERVIEW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1202
Mailing Address - Country:US
Mailing Address - Phone:210-255-8935
Mailing Address - Fax:210-255-8026
Practice Address - Street 1:4611 CENTERVIEW
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1202
Practice Address - Country:US
Practice Address - Phone:210-255-8935
Practice Address - Fax:210-255-8026
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0451207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine