Provider Demographics
NPI:1851350276
Name:MOSS, ROBERT NATHAN (PT, SCD, OCS, FAAOMP)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NATHAN
Last Name:MOSS
Suffix:
Gender:M
Credentials:PT, SCD, OCS, FAAOMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HIGHLAND RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-7163
Mailing Address - Country:US
Mailing Address - Phone:817-220-6677
Mailing Address - Fax:817-220-6617
Practice Address - Street 1:101 HIGHLAND RD STE 1
Practice Address - Street 2:
Practice Address - City:SPRINGTOWN
Practice Address - State:TX
Practice Address - Zip Code:76082-7163
Practice Address - Country:US
Practice Address - Phone:817-220-6677
Practice Address - Fax:817-220-6617
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1125003225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2951Medicare ID - Type Unspecified