Provider Demographics
NPI:1205106804
Name:DAN H. ROBERTS, PH.D., P.C.
Entity type:Organization
Organization Name:DAN H. ROBERTS, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-388-2006
Mailing Address - Street 1:PO BOX 2562
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78680-2562
Mailing Address - Country:US
Mailing Address - Phone:512-388-2006
Mailing Address - Fax:512-388-5886
Practice Address - Street 1:600 ROUND ROCK WEST DR
Practice Address - Street 2:STE. 701
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5007
Practice Address - Country:US
Practice Address - Phone:512-388-2006
Practice Address - Fax:512-388-5886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22667103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty