Provider Demographics
NPI:1376507681
Name:FERGUSON, ROBIN LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:LYNN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 AVENUE F N
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3167
Mailing Address - Country:US
Mailing Address - Phone:979-245-2008
Mailing Address - Fax:979-314-7164
Practice Address - Street 1:2112 REGIONAL MEDICAL DR STE 1317
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-1413
Practice Address - Country:US
Practice Address - Phone:979-245-2008
Practice Address - Fax:979-314-7164
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7530207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5434725OtherAETNA HEALTH INSURANCE
10588226OtherCAQH
TX045824206Medicaid
TXH08MD26401OtherBCBS OF TX
TX8DE527OtherBC/BS #
TXP01090447OtherRAILROAD MEDICARE PTAN
TX100012590OtherRAILROAD GBA - RAILROAD MEDICARE
TX87888JMedicare ID - Type Unspecified
TX045824201Medicaid