Provider Demographics
NPI:1356315782
Name:MCINTOSH, ROBERT WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:MCINTOSH
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:512 VICTORIA LN
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3226
Mailing Address - Country:US
Mailing Address - Phone:956-421-5660
Mailing Address - Fax:956-421-5670
Practice Address - Street 1:512 VICTORIA LN
Practice Address - Street 2:SUITE 5
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3226
Practice Address - Country:US
Practice Address - Phone:956-421-5660
Practice Address - Fax:956-421-5670
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2013-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM8177207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB163697Medicare PIN