1750384806 NPI number — DR. ROBERT BISBEE MD

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	BISBEE
Provider First Name	:	ROBERT
Provider Middle Name	:
Provider Name Prefix Text	:	DR.
Provider Name Suffix Text	:
Provider Credential Text	:	MD
Provider Gender Code	:	M

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Provider Other First Name	:
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NPI Number	:	1750384806
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	07/09/2007
NPI Deactivation Reason Code	:
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Provider First Line Business Mailing Address	:	5219 CITY BANK PKWY
Provider Second Line Business Mailing Address	:	STE 35
Provider Business Mailing Address City Name	:	LUBBOCK
Provider Business Mailing Address State Name	:	TX
Provider Business Mailing Address Postal Code	:	794073545
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	8067852045
Provider Business Mailing Address Fax Number	:	8067222908

Provider First Line Business Practice Location Address	:	113 WALNUT ST
Provider Second Line Business Practice Location Address	:
Provider Business Practice Location Address City Name	:	IDALOU
Provider Business Practice Location Address State Name	:	TX
Provider Business Practice Location Address Postal Code	:	793294003
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	8068922537
Provider Business Practice Location Address Fax Number	:	8068922726
Provider Enumeration Date	:	05/23/2005

Authorized Official Last Name	:
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• Taxonomy code: 207R00000X , with the licence number:  J8461 , registered in the state of TX .

• Identifier: G22052 , issued by the state of ( TX ) . This identifiers is of the category "".