Provider Demographics
NPI:1629076757
Name:NARVAEZ, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:NARVAEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12602 TOEPPERWEIN RD
Mailing Address - Street 2:STE 205
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3271
Mailing Address - Country:US
Mailing Address - Phone:210-650-9119
Mailing Address - Fax:210-650-9681
Practice Address - Street 1:12602 TOEPPERWEIN RD
Practice Address - Street 2:SUITE 208
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3269
Practice Address - Country:US
Practice Address - Phone:210-650-9119
Practice Address - Fax:210-650-9681
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5014174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031692901Medicaid
TX00A42PMedicare PIN
TX031692901Medicaid