Provider Demographics
NPI:1306822366
Name:DAY, ROBERT EMMETT JR (OD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EMMETT
Last Name:DAY
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3034 BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-3732
Mailing Address - Country:US
Mailing Address - Phone:972-278-2121
Mailing Address - Fax:972-726-1573
Practice Address - Street 1:3034 BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-3732
Practice Address - Country:US
Practice Address - Phone:972-278-2121
Practice Address - Fax:972-726-1573
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2016-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2306TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000000E15GOtherBCBS
TX751790940OtherVSP
T12949Medicare UPIN
TX80076EMedicare ID - Type Unspecified