Provider Demographics
NPI:1376878090
Name:KENT, ROBIN DENISE (PA/C)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:DENISE
Last Name:KENT
Suffix:
Gender:F
Credentials:PA/C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 JOE RAMSEY BLVD E STE 100
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7856
Mailing Address - Country:US
Mailing Address - Phone:903-455-4767
Mailing Address - Fax:
Practice Address - Street 1:700 N HWY 78
Practice Address - Street 2:
Practice Address - City:LEONARD
Practice Address - State:TX
Practice Address - Zip Code:75452
Practice Address - Country:US
Practice Address - Phone:903-587-0287
Practice Address - Fax:903-587-0298
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45-3883OtherMEDICARE RHC NUMBER