Provider Demographics
NPI:1881690188
Name:NOLAND, ROBERT ELDRIDGE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ELDRIDGE
Last Name:NOLAND
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:524 SINGING OAKS STE 200
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6509
Mailing Address - Country:US
Mailing Address - Phone:830-980-8433
Mailing Address - Fax:830-980-8442
Practice Address - Street 1:524 SINGING OAKS STE 200
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78070-6509
Practice Address - Country:US
Practice Address - Phone:830-980-8433
Practice Address - Fax:830-980-8442
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM6315207Q00000X
MSMS18106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L3832OtherWELLMED MEDICARE
TX3083560-01OtherWELLMED MEDICAID
MS080003950Medicare ID - Type Unspecified
TX8L3832OtherPRINCETON MEDICAL GROUP PA