Provider Demographics
NPI:1629053319
Name:MOTT, ROBERT ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDREW
Last Name:MOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 W UNIVERSITY DR
Mailing Address - Street 2:STE.100
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-4816
Mailing Address - Country:US
Mailing Address - Phone:972-562-6330
Mailing Address - Fax:972-562-6350
Practice Address - Street 1:4685 W UNIVERSITY DR
Practice Address - Street 2:STE.100
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-4816
Practice Address - Country:US
Practice Address - Phone:972-562-6330
Practice Address - Fax:972-562-6350
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV08356Medicare UPIN