Provider Demographics
NPI:1295032696
Name:ARRICIVITA, ROBERT (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:ARRICIVITA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 EMMET HUTTO BLVD APT 1101
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-1793
Mailing Address - Country:US
Mailing Address - Phone:818-274-6740
Mailing Address - Fax:
Practice Address - Street 1:4000 GARTH RD
Practice Address - Street 2:SUITE 140
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3168
Practice Address - Country:US
Practice Address - Phone:281-427-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1190565225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist