Provider Demographics
NPI:1265476998
Name:WOODROME, ROBERT GALE (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GALE
Last Name:WOODROME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1939
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-0037
Mailing Address - Country:US
Mailing Address - Phone:936-327-9944
Mailing Address - Fax:936-327-9945
Practice Address - Street 1:14006 OLD HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:SPLENDORA
Practice Address - State:TX
Practice Address - Zip Code:77372-6302
Practice Address - Country:US
Practice Address - Phone:281-689-6901
Practice Address - Fax:281-689-6779
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1499207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8V4300OtherBLUE CROSS/BLUE SHIELD
TX8V4300OtherBLUE CROSS/BLUE SHIELD