Provider Demographics
NPI:1235111063
Name:CROSS, ROBERT MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:CROSS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N TRAVIS ST STE 303
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-0004
Mailing Address - Country:US
Mailing Address - Phone:903-819-8888
Mailing Address - Fax:903-870-0304
Practice Address - Street 1:200 N TRAVIS ST
Practice Address - Street 2:STE 303
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-0004
Practice Address - Country:US
Practice Address - Phone:972-658-1144
Practice Address - Fax:903-870-0304
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2019-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24945103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0952426Medicaid
TX00L63AMedicare ID - Type Unspecified