Provider Demographics
NPI:1053283994
Name:ROTIBI, BIOLA
Entity type:Individual
Prefix:
First Name:BIOLA
Middle Name:
Last Name:ROTIBI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5963 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0444
Mailing Address - Country:US
Mailing Address - Phone:972-876-2427
Mailing Address - Fax:
Practice Address - Street 1:5963 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0444
Practice Address - Country:US
Practice Address - Phone:972-876-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist