Provider Demographics
NPI:1497142558
Name:VASQUEZ, ROBERT JESS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JESS
Last Name:VASQUEZ
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 1:800 NE 1470
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-9144
Mailing Address - Country:US
Mailing Address - Phone:432-557-8533
Mailing Address - Fax:
Practice Address - Street 1:800 NE 1470
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-9144
Practice Address - Country:US
Practice Address - Phone:432-557-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3082207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS3082OtherTEXAS MEDICAL LICENSE