Provider Demographics
NPI:1740383652
Name:MIZE, ROBY DAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBY
Middle Name:DAN
Last Name:MIZE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8210 WALNUT HILL LN
Mailing Address - Street 2:SUITE 418, LB 37
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4405
Mailing Address - Country:US
Mailing Address - Phone:214-484-7912
Mailing Address - Fax:214-484-7912
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:SUITE 418, LB 37
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4405
Practice Address - Country:US
Practice Address - Phone:214-484-7912
Practice Address - Fax:214-484-7912
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2016-01-15
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Provider Licenses
StateLicense IDTaxonomies
TXE0559207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B24939Medicare UPIN