Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 108041 | TX |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 108041 | TX |
NPI | 1669796850 |
---|---|
Provider Name | Mr. Robert Keith Paul |
First Address | Richardson, TX 75082-4302 |
Second Address | Richardson, TX 75082-4302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2010 |
Last Update Date | 29/03/2018 |