Provider Demographics
NPI:1275697062
Name:GEORGE R ROBISON MD PA
Entity Type:Organization
Organization Name:GEORGE R ROBISON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-837-2937
Mailing Address - Street 1:1000 PAYTON GIN RD
Mailing Address - Street 2:STE S
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-6766
Mailing Address - Country:US
Mailing Address - Phone:512-837-2937
Mailing Address - Fax:512-837-7181
Practice Address - Street 1:1000 PAYTON GIN RD
Practice Address - Street 2:STE S
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-6766
Practice Address - Country:US
Practice Address - Phone:512-837-2937
Practice Address - Fax:512-837-7181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6586207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081414701Medicaid
TX081414701Medicaid