LARRY C ROBERTS (NPI# 1578565859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578565859 |
| Entity Type | Individual |
| Full Name | LARRY C ROBERTS |
| Credential | MD |
| Practice Address |
2005 N 2nd Ave Ste D Canyon TX 79015-2545 |
| Mailing Address |
2005 N 2nd Ave Canyon TX 79015-2544 |
| Practice Telephone | 8065103376 |
| Practice Fax Number | 8065103379 |
| Mailing Telephone | 8065103376 |
| Mailing Fax Number | 8065103379 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2016-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
E8856 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE RAILROAD | 070002897 | 01 |
| TX | BLUE CROSS BLUE SHIELD | 807985 | 01 |
| TX | 037631101 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740685247 | Larry Roberts | Specialist | 23433 Carlow Rd, Torrance, CA 90505-4557 | 2014-10-27 |
| 1679826507 | Larry Roberts | Counselor | 5546 Camino Al Norte, Ste 2 A 2 301, North Las Vegas, NV 89031-0805 | 2012-10-16 |
| 1760558639 | Larry D Roberts | Dentist | 415 Waterfall Dr, Elkhart, IN 46516-3660 | 2006-11-24 |
| 1346344488 | Larry Kent Roberts | Dentist | 3101 Burnet Ave, Cincinnati, OH 45229-3014 | 2006-09-11 |
| 1124038310 | Larry L. Roberts II | Marriage & Family Therapist | 1 W 10th St, Shawnee, OK 74801-6801 | 2006-08-09 |
| 1598703795 | Larry K Roberts | Radiology | 5959 Park Ave, Radiology Department, Memphis, TN 38119-5200 | 2006-06-02 |
| 1134182876 | Larry P Roberts | Urology | 175 Memorial Hwy, Suite 3-2, New Rochelle, NY 10804 | 2006-04-11 |
| Street Address |
2005 N 2ND AVE STE D |
| City | CANYON |
| State | TX |
| Zip Code | 79015-2545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699120048 | Palo Duro Dermatology, Pllc | Dermatology | 2005 N 2nd Ave Ste D, Canyon, TX 79015-2545 | 2016-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194195826 | Melani Kelly | Specialist/Technologist | 702 3rd Avenue, Canyon, TX 79015 | 2015-10-07 |
| 1063846111 | Erin Ann Park | Physical Medicine & Rehabilitation | 907 23rd St., Canyon, TX 79015 | 2013-08-26 |
| 1003177197 | True Blessings LLC | Home Health | 1317 4th Avenue, Canyon, TX 79015 | 2012-06-05 |
| 1245460625 | Gloria Lewis | Nurse Practitioner | 1619 4th Ave, Canyon, TX 79015 | 2009-07-21 |
| 1376669861 | Assisted Living Concepts Inc | Assisted Living Facility | 2 Cottonwood Lane, Canyon, TX 79015 | 2007-03-22 |
| 1376568642 | D'aun Chrie Bowers | Emergency Medicine | 500 20th St, Canyon, TX 79015 | 2006-07-13 |
| 1760931497 | Kershen Health Services | Physical Therapist | 1613 4th Ave, Canyon, TX 79015 | 2016-09-22 |
| 1568730034 | Katherine Sheri Rogers | Physical Therapist | 15 Hospital Drive, Canyon, TX 79015 | 2011-12-12 |
| 1437273158 | Tommy W Brian I | Nurse Practitioner | 911 23rd St, Canyon, TX 79015 | 2007-03-19 |
| 1194377754 | Emily Collins | Occupational Therapist | 18 Case Ln, Canyon, TX 79015-1796 | 2019-07-14 |
| Find all providers in zip 79015 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467826131 | Medica Skin Diagnostics Pllc | Dermatology | 2046 Bedford Rd, Bedford, TX 76021-5709 | 2015-11-18 |
| 1942639455 | Dr. Samuel F Bean, Md, Pa | Dermatology | 1200 Binz St Ste 1110, Houston, TX 77004-6935 | 2013-11-05 |
| 1831417211 | Adaobi Nwaneshiudu Obasi | Dermatology | 6801 Mcpherson Rd Ste 332, Laredo, TX 78041-6417 | 2010-05-11 |
| 1366679466 | Ameripath 501a Corporation | Dermatology | 2330 Butler Street, Suite 115, Dallas, TX 75235-7800 | 2009-06-16 |
| 1104091487 | Galveston Dermatology, P.a. | Dermatology | 1501 Broadway Ave, Galveston, TX 77550 | 2008-04-28 |
| 1093865545 | Tracie Denise Swayden | Dermatology | 804 Ne Mall Blvd, Hurst, TX 76053-4653 | 2007-01-10 |
| 1265507941 | Angela Yen Moore, Md Pa | Dermatology | 711 E Lamar Blvd, Suite 200, Arlington, TX 76011-3888 | 2006-11-21 |
| 1568531739 | Melissa P Chiang | Dermatology | 5061 Fm 2920, Spring, TX 77388 | 2006-11-06 |
| 1962430108 | Andrew Marlin Morgan | Dermatology | 1001 N Twin Creek Dr, #201, Killeen, TX 76543-4268 | 2006-06-28 |
| 1245274331 | Anne E Wilkerson | Dermatology | 3010 Williams Dr, Suite 210, Georgetown, TX 78628-2764 | 2006-06-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.