Healthcare Provider Details

I. General information

NPI: 1487454773
Provider Name (Legal Business Name): AUSTIN LEE ROBERTS DPT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2025
Last Update Date: 03/15/2025
Certification Date: 03/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 WEST LOOP S
HOUSTON TX
77081-2206
US

IV. Provider business mailing address

5711 SUGAR HILL DR APT 35
HOUSTON TX
77057-2120
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-9000
  • Fax:
Mailing address:
  • Phone: 307-330-6909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number1322254
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: