Basic Information
Provider Information
NPI: 1124566419
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORGAN
FirstName: ROBERT
MiddleName: ZACHARY
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12508 JONES MALTSBERGER RD
Address2: 110
City: SAN ANTONIO
State: TX
PostalCode: 782474214
CountryCode: US
TelephoneNumber: 8885904002
FaxNumber: 2105904585
Practice Location
Address1: 10526 W PARMER LN
Address2: STE. 403
City: AUSTIN
State: TX
PostalCode: 787175056
CountryCode: US
TelephoneNumber: 5129003302
FaxNumber: 5129003321
Other Information
ProviderEnumerationDate: 02/07/2017
LastUpdateDate: 02/07/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1287176TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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