Provider Demographics
NPI:1467447474
Name:ROBERTS, BARBARA LOVE (CRNA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LOVE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:CRNA
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 650865
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0865
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:1500 CITYWEST BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-2300
Practice Address - Country:US
Practice Address - Phone:713-620-4000
Practice Address - Fax:713-458-4229
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP101680367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126049908Medicaid
TX126049916Medicaid
TX156178902Medicaid
TXP00005618OtherRAILROAD MEDICARE
TX014497OtherRECERTIFICATION AANA
TX83288UOtherBLUE CROSS BLUE SHIELD
TX002439001Medicaid
TX126049916OtherRR MEDICARE
TX81095HOtherUT - BCBSTX
TX89275COtherBCBS
R72984Medicare UPIN
TXP00005618OtherRAILROAD MEDICARE
TX288884YK6UMedicare PIN