Mckenzie, Robert Wayne

Mckenzie, Robert Wayne is an sole proprietor health care provider with primary practice located at 933 W Connally St , Tyler TX 75701-1404. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Mckenzie, Robert Wayne can be contacted via phone (903) 581-5714.

Contact Information

Primary practice address
933 W Connally St Tyler TX 75701-1404
Phone: (903) 581-5714
Fax: (903) 534-1507
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 25161 Texas

Profile Details

NPI number 1700905957
LBN Legal business name Mckenzie, Robert Wayne
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2007
Last updated Jun 2nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700905957 NPPES
Texas MEDICAID 100340204
Texas Other P00254134

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