Provider Demographics
NPI:1225033954
Name:PLATT, NANCY JANE (RPT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JANE
Last Name:PLATT
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21122 STATE HIGHWAY 71 W
Mailing Address - Street 2:UNIT B
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-6120
Mailing Address - Country:US
Mailing Address - Phone:512-264-9981
Mailing Address - Fax:512-264-9978
Practice Address - Street 1:21122 STATE HIGHWAY 71 W
Practice Address - Street 2:UNIT B
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-6120
Practice Address - Country:US
Practice Address - Phone:512-264-9981
Practice Address - Fax:512-264-9978
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1105518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T1404OtherBCBS TX
TX8T1404OtherBCBS TX