Provider Demographics
NPI:1356826465
Name:CHOATE, DEBORAH ANN (PTA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:CHOATE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:CHOATE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:303 ALPINE ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-5602
Mailing Address - Country:US
Mailing Address - Phone:432-559-8951
Mailing Address - Fax:
Practice Address - Street 1:2800 N MIDLAND DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5536
Practice Address - Country:US
Practice Address - Phone:432-697-3108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2055229225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant