Roberts, Larry C

Roberts, Larry C is an individual health care provider with primary practice located at 2005 N 2Nd Ave Ste D , Canyon TX 79015-2545. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Roberts, Larry C can be contacted via phone (806) 510-3376.

Contact Information

Primary practice address
2005 N 2Nd Ave Ste D Canyon TX 79015-2545
Phone: (806) 510-3376
Fax: (806) 510-3379
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X E8856 Texas
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1578565859
LBN Legal business name Roberts, Larry C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Oct 18th, 2016 - about 8 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 1578565859 NPPES
Texas Other 070002897 MEDICARE RAILROAD
Texas Other 807985 MEDICARE RAILROAD
Texas MEDICAID 037631101 MEDICARE RAILROAD

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