Colvin Earl Robertson Jr., PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS36568 Issued in FL

Practice address

13027 State Highway 155 S Ste 200
Tyler, TX 75703-6564

Phone

(430) 562-9003

Fax

(430) 562-9004

NPI assigned

Apr 29, 2016

Last updated

Oct 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Goodvalue Pharmacy LLC

  dba Good Value Pharmacy

  • Community/Retail Pharmacy
  • Schertz, TX
  • NPI 1629601489
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1487009205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 TROUP HWY STE 402",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032358",
            "telephone_number": "039-617-6885",
            "fax_number": "903-792-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13027 STATE HIGHWAY 155 S STE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036564",
            "telephone_number": "430-562-9003",
            "fax_number": "430-562-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "COLVIN",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-29",
        "last_updated": "2021-10-05",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "48543",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS36568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Liane Roberts, MD
• Ron L Roberts, MS
• Steven Bruce Roberts, MD
• Timothy Duane Roberts, LICENSED PROFESSIONA
• Bradley Robertson, MD
• Edwin D Robertson, PHD
• Dolar Robinett, COTA
• Judith M Robinett, L.P.C.
• Charles Edward Robinson Jr., DDS
• Jaelee R Robinson

• Pharmacist in Tyler, TX
• Providers in Tyler, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.