Provider Demographics
NPI:1124031059
Name:ROBINS, MAUREEN T X (DOM)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:T
Last Name:ROBINS
Suffix:X
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 ALLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-8803
Mailing Address - Country:US
Mailing Address - Phone:505-988-1774
Mailing Address - Fax:505-988-8960
Practice Address - Street 1:823 ALLENDALE ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-8803
Practice Address - Country:US
Practice Address - Phone:505-988-1774
Practice Address - Fax:505-988-8960
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM657RX1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00NM00RF34OtherBLUE CROSS BLUE SHIELD