Individual provider Active NPI

Robert Wesley Anderson III, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1740351048
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L9071 Issued in TX
Practice address
8200 Walnut Hill LN
Dallas, TX 75231
Phone
(214) 345-6789
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-114316 IL
Internal Medicine Physician 207R00000X L9071 TX Primary

Addresses

Primary practice location

8200 Walnut Hill LN
Dallas, TX 75231

Mailing address

4518 Gilbert Ave
Dallas, TX 75219-2121
Phone (773) 885-1665

Other practice location 1

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-8080

Other practice location 2

1775 Dempster St
Park Ridge, IL 60068
Phone (847) 723-8080

Other identifiers 1

IdentifierTypeStateIssuer
167864101MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014001091 TX Practitioner - Internal Medicine 0345200242 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-114316ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Nov 13, 2017 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince May 1, 2015 Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Nov 13, 2017 Accepting new patients

Locations

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

8200 Walnut Hill Ln
Ste 830
Dallas, TX 75231
Phone (214) 345-7999

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1740351048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4518 GILBERT AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192121",
            "telephone_number": "773-885-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WALNUT HILL LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231",
            "telephone_number": "214-345-6789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681143",
            "country_code": "US",
            "telephone_number": "847-723-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "60068",
            "country_code": "US",
            "telephone_number": "847-723-8080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-114316",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L9071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167864101",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.