Provider Demographics
NPI:1811265085
Name:FICULA, ROBERT EVERETTE (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:EVERETTE
Last Name:FICULA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:307 E OVILLA RD STE 600
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-3896
Mailing Address - Country:US
Mailing Address - Phone:469-437-3344
Mailing Address - Fax:844-292-1456
Practice Address - Street 1:307 E OVILLA RD
Practice Address - Street 2:SUITE 600
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-3898
Practice Address - Country:US
Practice Address - Phone:469-437-3344
Practice Address - Fax:844-292-1456
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9051207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB146616Medicare PIN
TXTXB146618Medicare PIN
TXTXB146617Medicare PIN
TXTXB146612Medicare PIN