Roberts, Condred W

Roberts, Condred W is an individual health care provider with primary practice located at 3201 W Highway 22 , Corsicana TX 75110. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Roberts, Condred W can be contacted via phone (903) 654-6812.

Contact Information

Primary practice address
3201 W Highway 22 Corsicana TX 75110
Phone: (903) 654-6812
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 220314 Texas

Profile Details

NPI number 1770527947
LBN Legal business name Roberts, Condred W
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Mar 23rd, 2009 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770527947 NPPES
Texas Other 88170U BCBS
Texas MEDICAID 0023418-03 BCBS
Texas MEDICAID 002341804 BCBS

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