Provider Demographics
NPI:1932680477
Name:DOOLE, ROBERTA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:
Last Name:DOOLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 MARWICK DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6222
Mailing Address - Country:US
Mailing Address - Phone:214-213-9582
Mailing Address - Fax:
Practice Address - Street 1:3401 MARWICK DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6222
Practice Address - Country:US
Practice Address - Phone:214-213-9582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1012888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1012888OtherPT LICENSE