Basic Information
| Provider Information | |||||||||
| NPI: | 1073629093 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNIGHT | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5950 BRYANT IRVIN RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761324210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172944646 | ||||||||
| FaxNumber: | 8172944649 | ||||||||
| Practice Location | |||||||||
| Address1: | 5950 BRYANT IRVIN RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761324210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172944646 | ||||||||
| FaxNumber: | 8172944649 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 02/21/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1137743 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 8B6260 | 01 | TX | BLUE CROSS/BLUE SHIELD | OTHER |