Provider Demographics
NPI:1588607006
Name:BIRDWELL, ROBERT RANKIN (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RANKIN
Last Name:BIRDWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:690 N 14TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1449
Practice Address - Country:US
Practice Address - Phone:409-899-7180
Practice Address - Fax:409-899-7186
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5482207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX514864YZ21Medicaid
TX132726407Medicaid
TX135660202Medicaid
TX135660206Medicaid
TX135660210Medicaid
TX135660211Medicaid
TX135660201Medicaid
TX135660204Medicaid
TX8R1397OtherBLUE CROSS OF TEXAS
TX135660201Medicaid
TX514864YZ21Medicaid
TX900003895Medicare PIN
TX8G7490Medicare PIN
TXB21289Medicare UPIN
TX87774KMedicare PIN