Provider Demographics
NPI:1609094697
Name:GOBERT, DENISE (PT, PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:GOBERT
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 203686
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78720
Mailing Address - Country:US
Mailing Address - Phone:512-366-8117
Mailing Address - Fax:512-366-8117
Practice Address - Street 1:1215 RED RIVER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1921
Practice Address - Country:US
Practice Address - Phone:512-479-3541
Practice Address - Fax:512-366-8117
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1092682225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist