Provider Demographics
NPI:1780763458
Name:ROBLES-MEADOWS, CORINNE
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:ROBLES-MEADOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-6752
Mailing Address - Country:US
Mailing Address - Phone:210-521-1347
Mailing Address - Fax:
Practice Address - Street 1:9150 HUEBNER RD
Practice Address - Street 2:SUITE 170
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1558
Practice Address - Country:US
Practice Address - Phone:210-694-5900
Practice Address - Fax:210-694-5910
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103396225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103396OtherLICENSE#