Provider Demographics
NPI:1730121690
Name:WEISBERG, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:WEISBERG
Suffix:
Gender:M
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:2001 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 630
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2222
Practice Address - Country:US
Practice Address - Phone:972-256-3537
Practice Address - Fax:972-255-7916
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5984207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138084212Medicaid
TX138084203Medicaid
TX138084205Medicaid
TX138084206OtherCSHCN
TX8R1584OtherBLUE CROSS OF TEXAS
TX138084210Medicaid
TX138084204Medicaid
TX138084201Medicaid
TX85M498Medicare PIN
TXB27475Medicare PIN
TXB27475Medicare UPIN
TX138084212Medicaid
TX138084210Medicaid
TX138084201Medicaid
TX830006499Medicare PIN