Mckenzie, Robert Wayne
Mckenzie, Robert Wayne is an sole proprietor health care provider with primary practice located at 933 W Connally St , Tyler TX 75701-1404. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Mckenzie, Robert Wayne can be contacted via phone (903) 581-5714.Contact Information
Primary practice address
933 W Connally St
Tyler TX 75701-1404
Phone: (903) 581-5714
Fax: (903) 534-1507
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 25161 | Texas |
Profile Details
| NPI number | 1700905957 |
|---|---|
| LBN Legal business name | Mckenzie, Robert Wayne |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Jun 2nd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700905957 | NPPES |
| Texas | MEDICAID | 100340204 | |
| Texas | Other | P00254134 |
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