Provider Demographics
NPI:1801317243
Name:ROBINSON, JOEL (DPM)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10302 FAIRWAY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-8544
Mailing Address - Country:US
Mailing Address - Phone:972-832-9452
Mailing Address - Fax:
Practice Address - Street 1:119 MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2138
Practice Address - Country:US
Practice Address - Phone:903-885-2754
Practice Address - Fax:903-347-1207
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006868213ES0103X
TX3042213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery