Provider Demographics
NPI:1437343001
Name:TERRY M ROBINSON JR LPT INC.
Entity Type:Organization
Organization Name:TERRY M ROBINSON JR LPT INC.
Other - Org Name:GRAPEVINE PHYSICAL THERAPY & SPORTS MED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:MACK
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:817-481-3451
Mailing Address - Street 1:204 N DOOLEY ST.
Mailing Address - Street 2:STE 300
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051
Mailing Address - Country:US
Mailing Address - Phone:817-481-3451
Mailing Address - Fax:817-481-2543
Practice Address - Street 1:204 N DOOLEY ST.
Practice Address - Street 2:STE 300
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051
Practice Address - Country:US
Practice Address - Phone:817-481-3451
Practice Address - Fax:817-481-2543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055077225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00984VMedicare PIN