Roberts, Dwayne Lee
Roberts, Dwayne Lee is an individual health care provider with primary practice located at 1201 Summit Ave , Fort Worth TX 76102-4427. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Roberts, Dwayne Lee can be contacted via phone (817) 332-2020.Contact Information
Primary practice address
1201 Summit Ave
Fort Worth TX 76102-4427
Phone: (817) 332-2020
Fax: (817) 332-4797
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | L8921 | Texas |
Profile Details
| NPI number | 1114923083 |
|---|---|
| LBN Legal business name | Roberts, Dwayne Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2005 |
| Last updated | May 13th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114923083 | NPPES |
| Texas | MEDICAID | 166464101 | |
| Texas | Other | 8J0403 | |
| Texas | MEDICAID | 166464102 |
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