Healthcare Provider Details

I. General information

NPI: 1164800033
Provider Name (Legal Business Name): ROBIN JESSUP MS, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2015
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12500 DALLAS PKWY
FRISCO TX
75033-4231
US

IV. Provider business mailing address

2990 LEGACY DR
FRISCO TX
75034-6066
US

V. Phone/Fax

Practice location:
  • Phone: 469-604-9000
  • Fax: 214-645-0078
Mailing address:
  • Phone: 469-888-5172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number1182980
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1182980
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: