Provider Demographics
NPI:1528414570
Name:ROBERTSON, MINDY (RLC)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2873 MATCH POINT LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4867
Mailing Address - Country:US
Mailing Address - Phone:832-264-9656
Mailing Address - Fax:
Practice Address - Street 1:2873 MATCH POINT LN
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4867
Practice Address - Country:US
Practice Address - Phone:832-264-9656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN