Provider Demographics
NPI:1518968411
Name:CANBY, ROBERT CLAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLAY
Last Name:CANBY
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 1:3000 N INTERSTATE 35 STE 700
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1852
Mailing Address - Country:US
Mailing Address - Phone:512-807-3150
Mailing Address - Fax:512-458-7879
Practice Address - Street 1:3000 N IH 35
Practice Address - Street 2:SUITE 700
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1804
Practice Address - Country:US
Practice Address - Phone:512-807-3150
Practice Address - Fax:512-458-7879
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6090207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX060054443OtherMEDICARE RAILROAD
TX137561001Medicaid
TX137561012Medicaid
TX8L14542Medicare PIN
TX84111KMedicare PIN
TX060054443OtherMEDICARE RAILROAD
TX8758N3Medicare PIN
TXTXB103062Medicare PIN
TX137561012Medicaid