Provider Demographics
NPI:1386006492
Name:ROBINSON, AUDRA (MD)
Entity Type:Individual
Prefix:
First Name:AUDRA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5417 RIDGEPASS LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3082
Mailing Address - Country:US
Mailing Address - Phone:972-793-2259
Mailing Address - Fax:972-548-2753
Practice Address - Street 1:5417 RIDGEPASS LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-3082
Practice Address - Country:US
Practice Address - Phone:972-793-2259
Practice Address - Fax:972-548-2753
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1345HS207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology