Timothy Duane Roberts, LICENSED PROFESSIONA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

69790 Issued in TX

Practice address

104 E Front Street
Suite 142
Tyler, TX 75702

Phone

(903) 533-8008

Fax

(903) 533-8008

NPI assigned

Jul 11, 2008

Last updated

Jul 11, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1679737316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E FRONT STREET",
            "address_2": "SUITE 142",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75702",
            "telephone_number": "903-533-8008",
            "fax_number": "903-533-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E FRONT STREET",
            "address_2": "SUITE 142",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75702",
            "telephone_number": "903-533-8008",
            "fax_number": "903-533-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TIMOTHY",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "LICENSED PROFESSIONA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "69790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Roberts, LVN
• Paul B Roberts, MD
• Robyn Liane Roberts, MD
• Ron L Roberts, MS
• Steven Bruce Roberts, MD
• Bradley Robertson, MD
• Colvin Earl Robertson Jr., PHARM.D.
• Edwin D Robertson, PHD
• Dolar Robinett, COTA
• Judith M Robinett, L.P.C.

• Professional Counselor in Tyler, TX
• Providers in Tyler, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.