Provider Demographics
NPI:1730347790
Name:ROBEY, CHARLES A JR (PTA)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:A
Last Name:ROBEY
Suffix:JR
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 1:305 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2152
Mailing Address - Country:US
Mailing Address - Phone:903-736-6760
Mailing Address - Fax:
Practice Address - Street 1:3700 CROSS PARK DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-4137
Practice Address - Country:US
Practice Address - Phone:979-774-9958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2065979225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant