Provider Demographics
NPI:1922324359
Name:ROBINSON, ERIC EDWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:EDWARD
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 EVERETT DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6146
Mailing Address - Country:US
Mailing Address - Phone:512-504-5186
Mailing Address - Fax:512-504-5536
Practice Address - Street 1:4100 EVERETT DR
Practice Address - Street 2:SUITE 400
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6146
Practice Address - Country:US
Practice Address - Phone:512-504-5186
Practice Address - Fax:512-504-5536
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3263071-01Medicaid
TX3263071-02Medicaid
TX326307104Medicaid
TX326307103Medicaid
TX3263071-02Medicaid
TX313139YLP2Medicare PIN
TX313139YLP1Medicare PIN
TX326307103Medicaid