Provider Demographics
NPI:1528053741
Name:ROBERTS, LOUIE SANFORD (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIE
Middle Name:SANFORD
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BAYSHORE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1952
Mailing Address - Country:US
Mailing Address - Phone:713-944-0229
Mailing Address - Fax:713-946-9448
Practice Address - Street 1:3333 BAYSHORE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1952
Practice Address - Country:US
Practice Address - Phone:713-944-0229
Practice Address - Fax:713-946-9448
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6268174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8541B0Medicare ID - Type Unspecified
TXG79957Medicare UPIN