Provider Demographics
NPI:1477282721
Name:ORR, ROBERT DALE (RN)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DALE
Last Name:ORR
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12225 COUNTY ROAD 4088
Mailing Address - Street 2:
Mailing Address - City:SCURRY
Mailing Address - State:TX
Mailing Address - Zip Code:75158-2939
Mailing Address - Country:US
Mailing Address - Phone:214-538-5683
Mailing Address - Fax:
Practice Address - Street 1:2418 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GUN BARREL CITY
Practice Address - State:TX
Practice Address - Zip Code:75156-3638
Practice Address - Country:US
Practice Address - Phone:903-713-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX923897163W00000X
TX1086303363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse