Provider Demographics
NPI:1851681720
Name:ROBINSON, CHARLA (CRT)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 543494
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-3494
Mailing Address - Country:US
Mailing Address - Phone:817-406-8626
Mailing Address - Fax:
Practice Address - Street 1:602 MAGIC MILE ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-5108
Practice Address - Country:US
Practice Address - Phone:817-406-8626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
227800000X, 372600000X
TXRCP02002267227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
No372600000XNursing Service Related ProvidersAdult Companion