Provider Demographics
NPI:1437263548
Name:CABALLERO, ROBERTO (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:
Last Name:CABALLERO
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:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-4268
Practice Address - Fax:682-885-7956
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9607207RC0200X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX109686100OtherFIRSTCARE PIN
TX1640387OtherFIRSTHEALTH PIN
TX10006567OtherAMERIGROUP PIN
TX129717806OtherCSHCN
TX00U87ZOtherBCBSTX GRP PIN
TX124033OtherSUPERIOR PIN
TX1392393OtherUHC PIN
1750369203OtherGRP NPI NUMBER
TX6464416OtherCIGNA PIN
TX82Y890OtherBCBSTX IND PIN
TX129717805Medicaid
TX4397102OtherAETNA PIN
TX1640387OtherFIRSTHEALTH PIN
TX129717805Medicaid