Provider Demographics
NPI:1912989369
Name:ROBINSON, MATTHEW MILES (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MILES
Last Name:ROBINSON
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 1:313 FM 517 RD W
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-4009
Mailing Address - Country:US
Mailing Address - Phone:281-967-7912
Mailing Address - Fax:281-967-7915
Practice Address - Street 1:313 FM 517 RD W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-4009
Practice Address - Country:US
Practice Address - Phone:281-967-7912
Practice Address - Fax:281-967-7915
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD98652208800000X
TXJ1130208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031044301Medicaid
TXF43385Medicare UPIN
TX8F1188Medicare PIN