Basic Information
| Provider Information | |||||||||
| NPI: | 1649630542 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBERSON | ||||||||
| FirstName: | MONICA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4100 N SAM HOUSTON PKWY W | ||||||||
| Address2: | STE 240 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770861465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133839700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4100 N SAM HOUSTON PKWY W | ||||||||
| Address2: | STE 240 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770861465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133839700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2016 | ||||||||
| LastUpdateDate: | 03/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 209156 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.