Provider Demographics
NPI:1013903624
Name:NAISMITH, ROBERT ALAN (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALAN
Last Name:NAISMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 TEXAN TRL
Mailing Address - Street 2:STE 100
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2547
Mailing Address - Country:US
Mailing Address - Phone:361-884-8631
Mailing Address - Fax:361-882-7716
Practice Address - Street 1:601 TEXAN TRL
Practice Address - Street 2:STE. 100
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2548
Practice Address - Country:US
Practice Address - Phone:361-884-8631
Practice Address - Fax:361-882-7716
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6615208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP0879021N4Medicaid
G91410Medicare UPIN
87021NMedicare ID - Type Unspecified