Basic Information
| Provider Information | |||||||||
| NPI: | 1164800033 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JESSUP | ||||||||
| FirstName: | ROBIN | ||||||||
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| Credential: | MS, PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2990 LEGACY DR | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750346066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4698885172 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12500 DALLAS PKWY | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750334231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4696049000 | ||||||||
| FaxNumber: | 2146450078 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2015 | ||||||||
| LastUpdateDate: | 03/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251N0400X | 1182980 | TX | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | 225100000X | 1182980 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.