Provider Demographics
NPI:1205010949
Name:DOUGLAS-DAVIS, ROBIN LEANN (PT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEANN
Last Name:DOUGLAS-DAVIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 JERNIGAN RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-8596
Mailing Address - Country:US
Mailing Address - Phone:214-679-4237
Mailing Address - Fax:
Practice Address - Street 1:581 JERNIGAN RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-8596
Practice Address - Country:US
Practice Address - Phone:214-679-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1109213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist