Basic Information
| Provider Information | |||||||||
| NPI: | 1225075864 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOWINGTON | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2452 LAKEWOOD DR | ||||||||
| Address2: | |||||||||
| City: | GRAND PRAIRIE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750546800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727432126 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2452 LAKEWOOD DR | ||||||||
| Address2: | |||||||||
| City: | GRAND PRAIRIE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750546800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727432126 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 08/05/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 70862 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 170335701 | 05 | TX | MEDICAID | 170335702 | 05 | TX | MEDICAID | BLUE CROSS-8C7577 | 01 | TX | ROBERT HOWINGTON, CRNA | OTHER | AMERIGROUP-10017669 | 01 | TX | ROBERT HOWINGTON, CRNA | OTHER |