Provider Demographics
NPI:1588677116
Name:ROBERTS, JAMES RONALD (PA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RONALD
Last Name:ROBERTS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:4500 S LANCASTER RD
Mailing Address - Street 2:CODE 112P
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:214-857-1878
Mailing Address - Fax:214-857-1840
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:CODE 112P
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-857-1878
Practice Address - Fax:214-857-1840
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical