Provider Demographics
NPI:1922582964
Name:COMPIAN, ROBERT (PTA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:COMPIAN
Suffix:
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 1:113 JO BETSY DR
Mailing Address - Street 2:
Mailing Address - City:CHINA SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:76633-2964
Mailing Address - Country:US
Mailing Address - Phone:254-717-9271
Mailing Address - Fax:
Practice Address - Street 1:457 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-1937
Practice Address - Country:US
Practice Address - Phone:979-968-5865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2030971225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant