Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Timothy Wayne Robertson Jr., LSA, CSA

Individual provider Surgical Physician Assistant · NPI 1538415583

Mr. Timothy Wayne Robertson Jr., LSA, CSA is a Surgical Physician Assistant in Katy, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2012

Practice location Address checks out

4427 N Vineyard Meadow Ln
Katy, TX 77449-3445
Phone: (832) 248-8635
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence SA00487 (TX)

Record details

NPI number1538415583
Entity typeIndividual (Type 1)
GenderMale
Credentials LSA , CSA
Sole proprietorYes
NPI enumeratedJuly 27, 2012
Last updated in NPPESJune 24, 2020
Certification dateJune 24, 2020

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