Provider Demographics
NPI:1205511862
Name:COMSTOCK, ROBIN (LAC)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:
Last Name:COMSTOCK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:RUBY
Other - Middle Name:
Other - Last Name:COMSTOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4315 JINX AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1024
Mailing Address - Country:US
Mailing Address - Phone:512-916-9749
Mailing Address - Fax:
Practice Address - Street 1:1825 FORTVIEW RD STE 112A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7656
Practice Address - Country:US
Practice Address - Phone:512-916-9749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXACO1305171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist