Provider Demographics
NPI:1235463928
Name:JAIME ROBLEDO MD PA
Entity Type:Organization
Organization Name:JAIME ROBLEDO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-590-5470
Mailing Address - Street 1:21830 KINGSLAND BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2500
Mailing Address - Country:US
Mailing Address - Phone:713-590-5470
Mailing Address - Fax:713-583-2800
Practice Address - Street 1:21830 KINGSLAND BLVD STE 102
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2500
Practice Address - Country:US
Practice Address - Phone:713-590-5470
Practice Address - Fax:713-583-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6916208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1942352604OtherNPI
TX1235463928OtherNPI