Provider Demographics
NPI:1700345253
Name:ROBINSON, ERAN MICHELLE
Entity type:Individual
Prefix:
First Name:ERAN
Middle Name:MICHELLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 S KENTUCKY ST STE B100
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79102-2224
Mailing Address - Country:US
Mailing Address - Phone:806-358-9400
Mailing Address - Fax:
Practice Address - Street 1:2329 ROSS OSAGE ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79103-7910
Practice Address - Country:US
Practice Address - Phone:063-505-7908
Practice Address - Fax:806-350-5791
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140967363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily