Provider Demographics
NPI:1659489243
Name:ROBBINS, WILLIAM W (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78291-0067
Mailing Address - Country:US
Mailing Address - Phone:210-614-9955
Mailing Address - Fax:210-614-9966
Practice Address - Street 1:4410 MEDICAL DR
Practice Address - Street 2:SUITE 390
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6306
Practice Address - Country:US
Practice Address - Phone:210-614-9955
Practice Address - Fax:210-614-9966
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0815207LP2900X, 207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099722303Medicaid
TX099722301Medicaid
TXA67574Medicare UPIN
TX099722301Medicaid
TX8F7953Medicare PIN