Provider Demographics
NPI:1932148574
Name:SHIRLEY, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:SHIRLEY
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 1:13811 MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4903
Mailing Address - Country:US
Mailing Address - Phone:713-772-1200
Mailing Address - Fax:713-255-6315
Practice Address - Street 1:17510 W GRAND PKWY S
Practice Address - Street 2:SUITE 490
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2645
Practice Address - Country:US
Practice Address - Phone:713-772-1200
Practice Address - Fax:281-342-3957
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9652208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
INI49262Medicare UPIN
TX556914ZK3JMedicare PIN
INI49262Medicare UPIN