Provider Demographics
NPI:1326057860
Name:KENT, ROBERT CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHARLES
Last Name:KENT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 W ARKANSAS LN
Mailing Address - Street 2:PANTEGO
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-6064
Mailing Address - Country:US
Mailing Address - Phone:817-261-3302
Mailing Address - Fax:817-277-0674
Practice Address - Street 1:2313 W ARKANSAS LN
Practice Address - Street 2:PANTEGO
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-6064
Practice Address - Country:US
Practice Address - Phone:817-261-3302
Practice Address - Fax:817-277-0674
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4157207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD97455Medicare UPIN
TXTXB101967Medicare PIN