Provider Demographics
NPI:1447257159
Name:METZGER, ROBERT LAVERN (FNP - B C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LAVERN
Last Name:METZGER
Suffix:
Gender:M
Credentials:FNP - B C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 NORTHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-2544
Mailing Address - Country:US
Mailing Address - Phone:972-998-0179
Mailing Address - Fax:214-590-2773
Practice Address - Street 1:4900 HARRY HINES BLVD
Practice Address - Street 2:2ND FLOOR ORTHOPAEDICS CLINIC
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7719
Practice Address - Country:US
Practice Address - Phone:214-590-9801
Practice Address - Fax:214-590-2773
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP110575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164503801Medicaid
TX164503801Medicaid
TX885178Medicare ID - Type Unspecified