Provider Demographics
NPI:1215191812
Name:ROBERSON, GARLAND STALLINGS (PHD)
Entity Type:Individual
Prefix:
First Name:GARLAND
Middle Name:STALLINGS
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25810 OAK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2016
Mailing Address - Country:US
Mailing Address - Phone:281-364-0067
Mailing Address - Fax:281-364-0712
Practice Address - Street 1:25810 OAK RIDGE DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2016
Practice Address - Country:US
Practice Address - Phone:281-364-0067
Practice Address - Fax:281-364-0712
Is Sole Proprietor?:No
Enumeration Date:2008-07-12
Last Update Date:2008-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33461103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist