Provider Demographics
NPI:1962476572
Name:ROBERTSON, COLETTE MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:COLETTE
Middle Name:MARGARET
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 EAST PINERIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1336
Mailing Address - Country:US
Mailing Address - Phone:830-591-7412
Mailing Address - Fax:
Practice Address - Street 1:600 EAST PINERIDGE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1336
Practice Address - Country:US
Practice Address - Phone:830-591-7412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6269207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK6269OtherMEDICAL LICENSE NUMBER
TX154083311Medicaid
TX8K4319Medicare PIN
TXK6269OtherMEDICAL LICENSE NUMBER