Provider Demographics
NPI:1437464856
Name:NOVAK, ROBYN
Entity Type:Individual
Prefix:MISS
First Name:ROBYN
Middle Name:
Last Name:NOVAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 UPTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7559
Mailing Address - Country:US
Mailing Address - Phone:956-544-7722
Mailing Address - Fax:956-544-7728
Practice Address - Street 1:140 UPTOWN AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7559
Practice Address - Country:US
Practice Address - Phone:956-544-7722
Practice Address - Fax:956-544-7728
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113391225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169033101Medicaid
TX45-4849OtherMEDICARE