Basic Information
| Provider Information | |||||||||
| NPI: | 1982681177 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEERTS | ||||||||
| FirstName: | ROBIN | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2222 WELBORN ST | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752193924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145595000 | ||||||||
| FaxNumber: | 2144437309 | ||||||||
| Practice Location | |||||||||
| Address1: | 5700 DALLAS PKWY | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750349580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4695157100 | ||||||||
| FaxNumber: | 4695157101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 08/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 706276 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 318468000 | 05 | MN | MEDICAID | 350C0WE | 01 | MN | MN BLUECROSS BS | OTHER | 1982681177 | 05 | IA | MEDICAID | 4993241 | 01 | SD | BLUE CROSS OF SD | OTHER | 46022474348 | 05 | NE | MEDICAID | 5755350 | 05 | SD | MEDICAID | 9248110 | 01 | SD | DAKOTACARE | OTHER |