| Doctor Name: | DR. ROBERTA LUCILLE VICKERY |
| NPI Number: | 1619297348 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 17751 |
| Business Practice Address: | 411 N Belknap St Stephenville, TX - 764013415 |
| Business Phone Number: | 8178204906 |
| Business Fax Number: | |
| Mailing Address: | 411 N Belknap St, STEPHENVILLE |
| State: | TX |
| Postal Code: | 764013415 |
| Phone Number: | 8178204906 |
| Fax Number: | |
| NPI Enumeration Date: | 06/04/2010 |
| NPI Last Update Date: | 09/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17751 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |