Provider Demographics
NPI:1861509432
Name:CRAMER, ROBERT CAMPBELL (PSY,D)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CAMPBELL
Last Name:CRAMER
Suffix:
Gender:M
Credentials:PSY,D
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 61226
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-1226
Mailing Address - Country:US
Mailing Address - Phone:361-442-4024
Mailing Address - Fax:361-853-7877
Practice Address - Street 1:4639 CORONA DR STE 34
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5430
Practice Address - Country:US
Practice Address - Phone:361-442-4024
Practice Address - Fax:361-806-9491
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15318101YP2500X
TX1778103K00000X
TX33980103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX027905102Medicaid
TX027905103Medicaid