Provider Demographics
NPI:1831659515
Name:ROBINSON, DENISHA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:DENISHA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 HAVEN LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5137
Mailing Address - Country:US
Mailing Address - Phone:817-937-9589
Mailing Address - Fax:
Practice Address - Street 1:3600 MATLOCK RD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3679
Practice Address - Country:US
Practice Address - Phone:817-467-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141090207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty