Provider Demographics
NPI:1588207344
Name:ROBERTS, HALEY MARGARET (PA-C)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MARGARET
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 PARK BEND DR BLDG 3-300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5386
Mailing Address - Country:US
Mailing Address - Phone:512-300-9520
Mailing Address - Fax:
Practice Address - Street 1:2200 PARK BEND DR BLDG 3-300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5386
Practice Address - Country:US
Practice Address - Phone:512-467-2727
Practice Address - Fax:512-873-7576
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13124363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical