Provider Demographics
NPI:1477846335
Name:SIGLIN, ROBERT JOSEPH (APRN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOSEPH
Last Name:SIGLIN
Suffix:
Gender:M
Credentials:APRN
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 748
Mailing Address - Street 2:MAIL ZONE 1864
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76101-7450
Mailing Address - Country:US
Mailing Address - Phone:817-777-8183
Mailing Address - Fax:817-777-1956
Practice Address - Street 1:1 LOCKHEED BLVD
Practice Address - Street 2:BUILDING 200/1/B22
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-3619
Practice Address - Country:US
Practice Address - Phone:817-777-8183
Practice Address - Fax:817-777-1956
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX552599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily