Provider Demographics
NPI:1225075864
Name:HOWINGTON, ROBERT MICHAEL (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MICHAEL
Last Name:HOWINGTON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2452 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-6800
Mailing Address - Country:US
Mailing Address - Phone:972-743-2126
Mailing Address - Fax:
Practice Address - Street 1:2452 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-6800
Practice Address - Country:US
Practice Address - Phone:972-743-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70862367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170335701Medicaid
TX170335702Medicaid
TXBLUE CROSS-8C7577OtherROBERT HOWINGTON, CRNA
TXAMERIGROUP-10017669OtherROBERT HOWINGTON, CRNA
TX170335702Medicaid
TXQ11842Medicare UPIN
TX8C6894Medicare ID - Type UnspecifiedROBERT HOWINGTON, CRNA