Provider Demographics
NPI:1679518104
Name:EAKER, ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:EAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 JENNY GEORGE LN
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-7152
Mailing Address - Country:US
Mailing Address - Phone:325-235-0770
Mailing Address - Fax:325-235-0771
Practice Address - Street 1:301 JENNY GEORGE LN
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-7152
Practice Address - Country:US
Practice Address - Phone:325-235-0770
Practice Address - Fax:325-235-0771
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7363207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00263ZMedicare ID - Type Unspecified
TXI01602Medicare UPIN