Provider Demographics
NPI:1821030412
Name:ROBERT H STROUD MD PA
Entity Type:Organization
Organization Name:ROBERT H STROUD MD PA
Other - Org Name:QUAIL CREEK EAR NOSE & THROAT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:STROUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-355-9999
Mailing Address - Street 1:6826 PLUM CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-1601
Mailing Address - Country:US
Mailing Address - Phone:806-355-9999
Mailing Address - Fax:806-355-9989
Practice Address - Street 1:6826 PLUM CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1601
Practice Address - Country:US
Practice Address - Phone:806-355-9999
Practice Address - Fax:806-355-9989
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT H STROUD MDPA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-11
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Y00000X, 231H00000X
TXK2806207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH39446Medicare UPIN
00092ZMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER