Provider Demographics
NPI:1003025628
Name:ROBINSON, DIANE C (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:C
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:6807 EMMETT F LOWRY EXPY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-2546
Mailing Address - Country:US
Mailing Address - Phone:409-935-2930
Mailing Address - Fax:409-935-2931
Practice Address - Street 1:6807 EMMETT F LOWRY EXPY
Practice Address - Street 2:SUITE 101
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2546
Practice Address - Country:US
Practice Address - Phone:409-935-2930
Practice Address - Fax:409-935-2931
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1720208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144544701Medicaid
TXP00644611Medicaid
TX8F8122Medicare PIN
TXG28091Medicare UPIN
TX00382QMedicare PIN