DR. WILLIAM JERRY ROBERTSON MD NPI 1346202579

NPI Information

  • NPI: 1346202579
  • Provider Name: DR. WILLIAM JERRY ROBERTSON, MD
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2604 ST MICHAEL DR
    STE 410
    TEXARKANA, TX
    ZIP 75503
  • Phone: (903) 614-5430

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NPI Details

DR. William Jerry Robertson, MD is an obstetrics gynecology in Texarkana, TX. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. William Jerry Robertson, MD NPI is 1346202579. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2604 ST MICHAEL DR
STE 410
TEXARKANA, TX
ZIP 75503-378
Phone: (903) 614-5430
Fax: (903) 614-5464

The NPI 1346202579 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/4/2006 and was last updated on 1/2/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyC5231ARKANSASNo
2207V00000XObstetrics & GynecologyG0817TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1124648002MEDICAIDTEXAS
2339663YMJMMEDICARE PINTEXAS
3103412001MEDICAIDARKANSAS
4124648005MEDICAIDTEXAS
5D08984MEDICARE UPIN
654444OTHERARKANSASBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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