Provider Demographics
NPI:1508848649
Name:ROBERT N EARLE MD PA
Entity Type:Organization
Organization Name:ROBERT N EARLE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:EARLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-218-8181
Mailing Address - Street 1:1560 W BAY AREA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2669
Mailing Address - Country:US
Mailing Address - Phone:281-218-8181
Mailing Address - Fax:281-218-7676
Practice Address - Street 1:1560 W BAY AREA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2669
Practice Address - Country:US
Practice Address - Phone:281-218-8181
Practice Address - Fax:281-218-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK02912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154460301Medicaid
TX0031QVOtherBC/BS OF TEXAS
TX154460301Medicaid
TX0031QVOtherBC/BS OF TEXAS
TXG54836Medicare UPIN