Provider Demographics
NPI:1962068049
Name:PLATT, ALINE (PTA)
Entity type:Individual
Prefix:
First Name:ALINE
Middle Name:
Last Name:PLATT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7767 SILVER STAR RD
Mailing Address - Street 2:
Mailing Address - City:SOUR LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:77659-5767
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:604 FM 1293 RD
Practice Address - Street 2:
Practice Address - City:KOUNTZE
Practice Address - State:TX
Practice Address - Zip Code:77625-7804
Practice Address - Country:US
Practice Address - Phone:409-246-3418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2058210225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant