Provider Demographics
NPI:1780465443
Name:ROBINSON, ROYCE FITZGERALD (MACC, BTH)
Entity type:Individual
Prefix:MR
First Name:ROYCE
Middle Name:FITZGERALD
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MACC, BTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17507 SALT RIVER VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2961
Mailing Address - Country:US
Mailing Address - Phone:281-962-8346
Mailing Address - Fax:832-644-8496
Practice Address - Street 1:17507 SALT RIVER VALLEY CIR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2961
Practice Address - Country:US
Practice Address - Phone:281-962-8346
Practice Address - Fax:832-644-8496
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral