Provider Demographics
NPI:1205834330
Name:WHALIN, ROBERT BRENT (MS PT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BRENT
Last Name:WHALIN
Suffix:
Gender:M
Credentials:MS PT
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Mailing Address - Street 1:2501 W WILLIAM CANNON DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5253
Mailing Address - Country:US
Mailing Address - Phone:512-416-7246
Mailing Address - Fax:512-416-6791
Practice Address - Street 1:2501 W WILLIAM CANNON DR
Practice Address - Street 2:SUITE 302
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5253
Practice Address - Country:US
Practice Address - Phone:512-416-7246
Practice Address - Fax:512-416-6791
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1132165225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4323OtherBLUE CROSS BLUE SHIELD
P35030Medicare UPIN
8D6911Medicare ID - Type Unspecified