Provider Demographics
NPI:1780849372
Name:HARTZLER, ROBERT U (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:U
Last Name:HARTZLER
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 1:400 CONCORD PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6905
Mailing Address - Country:US
Mailing Address - Phone:210-804-5630
Mailing Address - Fax:210-804-5633
Practice Address - Street 1:400 CONCORD PLAZA DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6905
Practice Address - Country:US
Practice Address - Phone:210-804-5630
Practice Address - Fax:210-804-5633
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115054207X00000X
MN51930207X00000X
390200000X
TXP7925207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAENROLLEDMedicaid
WIENROLLEDMedicaid
MNENROLLEDMedicaid
MNP01034518OtherRAILROAD MEDICARE
MN200002828Medicare PIN
MNP01034518OtherRAILROAD MEDICARE