Provider Demographics
NPI:1174663645
Name:ROBERT A. VOLLERO M.D.,P.A.
Entity type:Organization
Organization Name:ROBERT A. VOLLERO M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:VOLLERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-850-7272
Mailing Address - Street 1:6565 WEST LOOP S
Mailing Address - Street 2:STE 300
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3500
Mailing Address - Country:US
Mailing Address - Phone:713-850-7272
Mailing Address - Fax:713-877-0970
Practice Address - Street 1:6565 WEST LOOP S
Practice Address - Street 2:STE 300
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3500
Practice Address - Country:US
Practice Address - Phone:713-850-7272
Practice Address - Fax:713-877-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0576208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AJ425OtherBLUE CROSS BLUE SHIELD
TX8AJ425OtherBLUE CROSS BLUE SHIELD
TX00473TMedicare PIN