Provider Demographics
NPI:1225016694
Name:ROBINSON, DENNIS JAY (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JAY
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 BERQUIST DRIVE
Mailing Address - Street 2:SUITE 1 ATTN: CREDENTIALS (CMC)
Mailing Address - City:LACKLAND AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78236-6300
Mailing Address - Country:US
Mailing Address - Phone:830-719-1943
Mailing Address - Fax:
Practice Address - Street 1:2200 BERQUIST DRIVE
Practice Address - Street 2:SUITE 1 ATTN: CREDENTIALS (CMC)
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-6300
Practice Address - Country:US
Practice Address - Phone:830-719-1943
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant