Provider Demographics
NPI:1154334225
Name:ROBICHEAUX, DANIEL JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:ROBICHEAUX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 N MO PAC EXPY STE 230
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8962
Mailing Address - Country:US
Mailing Address - Phone:512-343-1959
Mailing Address - Fax:512-343-1987
Practice Address - Street 1:7800 N MO PAC EXPY STE 230
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8962
Practice Address - Country:US
Practice Address - Phone:512-343-1959
Practice Address - Fax:512-343-1987
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice