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Contact Information

ROBERT M SUPER, LAT, COF
1255 W 15TH ST STE 540
PLANO, TX75075-7248
 Phone: 410-845-3929
 Fax: 972-767-3728
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Orthotics/Prosthetics Fitter

225000000X
Indicates primary specialty

NPI Profile & details for ROBERT M SUPER · (Male)

NPI Number 1982838496
Status Active
Credentials LAT, COF
Entity Individual
Enumeration date 05/12/2009
Last updated 04/27/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • PA License # OF000004
  • PA License # RT005787
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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