Jack A Roberts, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1318000 Issued in TX

Practice address

4621 W Park Blvd Ste 102
Plano, TX 75093-2318

Phone

(972) 985-1776

Fax

(972) 985-6088

NPI assigned

Jun 4, 2019

Last updated

Jun 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1518525542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422453",
            "telephone_number": "713-297-6792",
            "fax_number": "713-430-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 W PARK BLVD STE 102",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750932318",
            "telephone_number": "972-985-1776",
            "fax_number": "972-985-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JACK",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1318000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Pine, PLLC Dba Hills and Valleys Counseling
• Robert Thomas, M.D., P.a.
• Saydee Angela Robert
• Allison Roberts, FNP-C
• Gregory D Roberts, M.D.
• John Paul Roberts, M.D.
• Jordan Leigh Roberts, PNP-AC
• Rebecca Ann Roberts, MD
• Robert L. Roberts, CRNA
• Sandi Roberts

• Physical Therapist in Plano, TX
• Providers in Plano, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.