Provider Demographics
NPI:1871706887
Name:ROBINSON, CAROL JEAN (PA-C)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JEAN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:796 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2895
Mailing Address - Country:US
Mailing Address - Phone:214-850-7132
Mailing Address - Fax:469-464-0367
Practice Address - Street 1:12050 LEBANON ROAD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-8298
Practice Address - Country:US
Practice Address - Phone:972-963-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01991363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS40755Medicare UPIN
TX83N003Medicare ID - Type Unspecified