Provider Demographics
NPI:1669421806
Name:TODD, ROBERT MAINORD II (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:MAINORD
Last Name:TODD
Suffix:II
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:PO BOX 51525
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-1525
Mailing Address - Country:US
Mailing Address - Phone:806-355-7286
Mailing Address - Fax:
Practice Address - Street 1:3501 S SONCY RD
Practice Address - Street 2:SUITE 116
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6407
Practice Address - Country:US
Practice Address - Phone:806-355-7286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1025207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF84906Medicare UPIN
83P506Medicare ID - Type UnspecifiedMEDICARE APG