Provider Demographics
NPI:1619934080
Name:ROBINSON, THERESA L (MD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7580 FANNIN ST
Mailing Address - Street 2:SUITE 235
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054
Mailing Address - Country:US
Mailing Address - Phone:713-795-0047
Mailing Address - Fax:713-795-4822
Practice Address - Street 1:7580 FANNIN ST
Practice Address - Street 2:SUITE 235
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-795-0047
Practice Address - Fax:713-795-4822
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8381207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032161401Medicaid
TX032161401Medicaid