Basic Information
| Provider Information | |||||||||
| NPI: | 1427034495 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBLES | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3418 MIDCOURT RD | ||||||||
| Address2: | SUITE 118 | ||||||||
| City: | CARROLLTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750064944 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3418 MIDCOURT RD | ||||||||
| Address2: | SUITE 118 | ||||||||
| City: | CARROLLTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750064944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144208200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2005 | ||||||||
| LastUpdateDate: | 09/02/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0101X | 34-008443 | OH | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | 056474 | GA | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | 2005-00398 | NC | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | 20A8161 | CA | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | L8923 | TX | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology |
No ID Information.