Provider Demographics
NPI:1679548382
Name:MARLEY, ROBERT RICHARD (ATC, LAT, CSCS)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RICHARD
Last Name:MARLEY
Suffix:
Gender:M
Credentials:ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 BLUE ROSE CIR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2906
Mailing Address - Country:US
Mailing Address - Phone:713-410-8041
Mailing Address - Fax:281-494-0515
Practice Address - Street 1:15200 SOUTHWEST FWY
Practice Address - Street 2:SUITE 175
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3845
Practice Address - Country:US
Practice Address - Phone:281-494-0550
Practice Address - Fax:281-494-0515
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT07072255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAT0707OtherTEXAS DEPT. OF HEALTH LIC