Healthcare Provider Details

I. General information

NPI: 1649333634
Provider Name (Legal Business Name): ROBERT K POHL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 3RD STREET WEST, BLDG. 1040
RANDOLPH AFB TX
78150-4801
US

IV. Provider business mailing address

17006 IRONGATE RAIL
SAN ANTONIO TX
78247-6217
US

V. Phone/Fax

Practice location:
  • Phone: 210-652-6403
  • Fax:
Mailing address:
  • Phone: 210-656-9658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA03033
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: