Provider Demographics
NPI:1285160168
Name:MATHIAS, ROBERT II (PTA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MATHIAS
Suffix:II
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 ARION PKWY STE 116
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2813
Mailing Address - Country:US
Mailing Address - Phone:210-366-2990
Mailing Address - Fax:210-499-4984
Practice Address - Street 1:1218 ARION PKWY STE 116
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2813
Practice Address - Country:US
Practice Address - Phone:210-366-2990
Practice Address - Fax:210-499-4984
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-0178-0225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant