MR. ROBERT DEAN BROADHEAD JR. (NPI# 1710530639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710530639 |
Entity Type | Individual |
Full Name | MR. ROBERT DEAN BROADHEAD JR. |
Credential | RT, MSRLS, CTRS, TRS |
Practice Address |
10815 Ranch Road 2222 Bldg 3b Austin TX 78730-1159 |
Mailing Address |
2110 Ranch Road 620 S Unit 341225 Lakeway TX 78734-0250 |
Practice Telephone | 5125535380 |
Practice Fax Number | 5125535380 |
Mailing Telephone | 5125535380 |
Mailing Fax Number | 5125329573 |
Enumeration Date | 2019-07-19 |
Last Update Date | 2020-10-31 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | 1463 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Y | 225800000X | Recreation Therapist | 82138 | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
N | 174H00000X | Health Educator | Other Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
1101 S Quinlan Park Rd, Austin, TX 787326074 | 5124688774 |
Street Address |
10815 RANCH ROAD 2222 BLDG 3B |
City | AUSTIN |
State | TX |
Zip Code | 78730-1159 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801421482 | Andbro Enterprises LLC | Community/Behavioral Health | 10815 Ranch Road 2222 Bldg 3b, Austin, TX 78730-1159 | 2020-03-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487295374 | Amaris Nicole Garza | Dietitian, Registered | 10301 Ranch To Market 2222, Apt #738, Austin, TX 78730 | 2019-10-02 |
1366093130 | Kotobi & Associates, LLC | In Home Supportive Care | 6101 W Courtyard Drive, Bldg 1, Suite 150, Austin, TX 78730 | 2019-09-24 |
1831653955 | Esther Wooten | Nurse Practitioner | 6500 River Place, Suite 102, Austin, TX 78730 | 2019-01-23 |
1629336243 | Yuri Alexander Lawrence | Internal Medicine | 7300 Ranch Road 2222, Austin, TX 78730 | 2012-05-02 |
1386914612 | Robin Marie Mccray Choban Han | Clinical Nurse Specialist | 6611 River Place Blvd Ste 203, Austin, TX 78730 | 2012-01-03 |
1437397106 | Collins Endodontics, PC | Dentist | 7300 Fm 2222, Building V, Suite 212, Austin, TX 78730 | 2009-02-03 |
1043471360 | Nadia Abboud Bening | Psychiatry & Neurology | 6611 Riverplace Blvd., Austin, TX 78730 | 2008-06-19 |
1740469089 | Healthy Achievers, Inc. | Nursing Care | 6300 Bridgepoint Parkway, Building 3, Suite 500, Austin, TX 78730 | 2007-11-02 |
1104948041 | Jack C. Tips | Nutritionist | 9419 Westminster Glen, Austin, TX 78730 | 2007-04-04 |
1407970841 | Us Radiology Partners of Texas Inc | Radiology | 3704 Lagood St, Austin, TX 78730 | 2007-03-19 |
Find all providers in zip 78730 |
Taxonomy Code | 225800000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Recreation Therapist |
A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |
Notes: Source: Joel A. DeLisa and Bruce M. Gans, Rehabilitation Medicine: Principles and Practice Second Edition, J.B. Lippincott Company, Philadelphia: 1993, p. 7 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881202240 | Brittany Danielle Lundeen | Recreation Therapist | 10320 Boulder Ln Apt 1317, Austin, TX 78726-1865 | 2020-07-21 |
1467066035 | Dara J Wise | Recreation Therapist | 5900 Balcones Dr, Austin, TX 78731-4257 | 2020-09-01 |
1134699226 | Christi L Zwicke | Recreation Therapist | 8601 Anderson Mill Rd, Austin, TX 78729-4700 | 2018-11-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609480250 | Shanteria Onyemem | Recreation Therapist | 3811 Glade Hill Ln, Richmond, TX 77407-3244 | 2020-09-01 |
1730790387 | Joan R Lamayo-buse | Recreation Therapist | 1853 Yount Cir, San Antonio, TX 78236-1007 | 2020-08-16 |
1750905816 | Ideal Recreational Therapies | Recreation Therapist | 19800 Kenswick Dr Apt 823, Humble, TX 77338-2159 | 2020-06-04 |
1184247645 | Joel Stephen Caltrider | Recreation Therapist | 3354 Putnam Flds, Converse, TX 78109-3808 | 2020-05-19 |
1396367405 | Caressa Blackman | Recreation Therapist | 5810 Utsa Blvd Apt 4202, San Antonio, TX 78249-4094 | 2020-05-12 |
1740801331 | Jasmine Mathew | Recreation Therapist | 15820 Christopher Lane, Frisco, TX 75035 | 2020-05-05 |
1083246862 | Meghan Elizabeth Scott | Recreation Therapist | 110 Contour Dr, Kerrville, TX 78028-6202 | 2020-02-10 |
1972135168 | Amanda Petri | Recreation Therapist | 1978 Kalli Jo Ln, New Braunfels, TX 78130-1960 | 2020-02-06 |
1346871969 | Requel Pace | Recreation Therapist | 4830 Wilson Rd Ste 300-1027, Humble, TX 77396-1971 | 2020-02-01 |
1881224277 | Tinyada Robinson | Recreation Therapist | 1777 Ne Interstate 410 Loop, Ste 1009, San Antonio, TX 78217 | 2020-01-24 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.