Individual ProviderKelly A RobersonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4206 Retama Cir, Victoria, TX 77901-2765(361) 582-0611PECOS EnrollmentBased on the most recent information from CMS, provider Kelly A Roberson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1265475008Provider TypeIndividualFull NameRoberson, Kelly ATitleMrs.CredentialPTGenderFemaleSole ProprietorNoEnumeration Date6/13/2006Last Updated7/15/2009Contact InformationPractice LocationPractice Address4206 Retama Cir, Victoria, TX 77901-2765Phone(361) 582-0611Fax(361) 582-0555Mailing LocationMailing Address4206 Retama Cir, Victoria, TX 77901-2765Phone(361) 582-0611Fax(361) 582-0555Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1154850TexasProvider IdentifiersIDDescriptionIssuerID164704201DescriptionMedicaidIssuerUnlistedTexas