Provider Demographics
NPI:1225590136
Name:ROBLES, ALEXIS ARNOLD (DO)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ARNOLD
Last Name:ROBLES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:MILTON FREEWATER
Mailing Address - State:OR
Mailing Address - Zip Code:97862-1518
Mailing Address - Country:US
Mailing Address - Phone:509-520-1419
Mailing Address - Fax:
Practice Address - Street 1:MSC10 5550 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-3983
Practice Address - Country:US
Practice Address - Phone:505-272-6331
Practice Address - Fax:505-272-0475
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program