Provider Demographics
NPI:1225797434
Name:LITTLE, TROY DON (LAT)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:DON
Last Name:LITTLE
Suffix:
Gender:M
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BAILEY RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-3110
Mailing Address - Country:US
Mailing Address - Phone:817-441-8711
Mailing Address - Fax:
Practice Address - Street 1:1000 BAILEY RANCH RD
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-3110
Practice Address - Country:US
Practice Address - Phone:817-441-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT24502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer