Provider Demographics
NPI:1255439154
Name:PUIG, ROBERT WALTON (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WALTON
Last Name:PUIG
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E DOVE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2241
Mailing Address - Country:US
Mailing Address - Phone:956-686-3434
Mailing Address - Fax:956-686-3340
Practice Address - Street 1:500 E DOVE AVE STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2241
Practice Address - Country:US
Practice Address - Phone:956-686-3434
Practice Address - Fax:956-686-3340
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0090014332B00000X
TX1151417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167955-01Medicaid
TX167955-01Medicaid