Provider Demographics
NPI:1487653705
Name:ROBERTS, DAVID ALLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLAN
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9150 HUEBNER RD STE 290
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1598
Mailing Address - Country:US
Mailing Address - Phone:210-614-6432
Mailing Address - Fax:210-615-3577
Practice Address - Street 1:9150 HUEBNER RD STE 290
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1598
Practice Address - Country:US
Practice Address - Phone:210-614-6432
Practice Address - Fax:210-615-3577
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG3733207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120194905Medicaid
TX120194905Medicaid
TX0988520001Medicare NSC
TXC21135Medicare UPIN