Basic Information
| Provider Information | |||||||||
| NPI: | 1609353374 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERT GROYSMAN MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1350 W WALNUT HILL LN STE 100 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750383025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145602000 | ||||||||
| FaxNumber: | 9725602555 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 W WALNUT HILL LN STE 100 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750383025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145602000 | ||||||||
| FaxNumber: | 9725602555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2018 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GROYSMAN | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2143027463 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | M5735 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | M5735 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 208VP0014X | M5735 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.