Provider Demographics
NPI:1164409108
Name:IZOR, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:IZOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12345 N LAMAR BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1347
Mailing Address - Country:US
Mailing Address - Phone:512-977-7000
Mailing Address - Fax:512-977-7001
Practice Address - Street 1:12345 N LAMAR BLVD STE 360
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-1337
Practice Address - Country:US
Practice Address - Phone:512-977-7000
Practice Address - Fax:512-977-7001
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL57762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH93348Medicare UPIN
TX8C6111Medicare ID - Type Unspecified