Provider Demographics
NPI:1730103037
Name:REILLY, ROBERT FRANKLIN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANKLIN
Last Name:REILLY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4500 S LANCASTER RD
Mailing Address - Street 2:111G1
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:214-857-1907
Mailing Address - Fax:214-857-1514
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:111G1
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-857-1907
Practice Address - Fax:214-857-1514
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT031533207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E82528Medicare UPIN