EDWIN D ROBERTSON PHD NPI 1649200700

NPI Information

  • NPI: 1649200700
  • Provider Name: EDWIN D ROBERTSON, PHD
  • Classification: Clinical Neuropsychologist - 103G00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 701 OLYMPIC PLAZA CIR
    TYLER, TX
    ZIP 75701
  • Phone: (903) 596-3000

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NPI Details

Edwin D Robertson, PHD is a clinical neuropsychologist in Tyler, TX with 36 years of experience. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Edwin D Robertson, PHD NPI is 1649200700. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

701 OLYMPIC PLAZA CIR
TYLER, TX
ZIP 75701-950
Phone: (903) 596-3000
Fax: (903) 596-3006

The NPI 1649200700 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Evaluation of neuropsychological test, first hour (HCPCS:96132)
  • Psychiatric diagnostic evaluation (HCPCS:90791)
  • Psychotherapy, 30 minutes (HCPCS:90832)

The enumeration date for this NPI number is 7/4/2006 and was last updated on 12/31/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical Neuropsychologist24420TEXASYes
2103T00000XPsychologist24420TEXASNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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