Provider Demographics
NPI:1548753999
Name:ROBINSON, PIERRE DEANTONIO (LMT 115919)
Entity Type:Individual
Prefix:MR
First Name:PIERRE
Middle Name:DEANTONIO
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LMT 115919
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 LONGHORN DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4446
Mailing Address - Country:US
Mailing Address - Phone:833-962-7724
Mailing Address - Fax:469-969-0098
Practice Address - Street 1:3401 CUSTER RD STE 181
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7599
Practice Address - Country:US
Practice Address - Phone:833-962-7724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115919225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty