Provider Demographics
NPI:1669796850
Name:PAUL, ROBERT KEITH (OTR)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:KEITH
Last Name:PAUL
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2150 LAKESIDE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4302
Mailing Address - Country:US
Mailing Address - Phone:214-329-9600
Mailing Address - Fax:214-329-9235
Practice Address - Street 1:2150 LAKESIDE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4302
Practice Address - Country:US
Practice Address - Phone:214-329-9600
Practice Address - Fax:214-329-9235
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108041225XP0019X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation