Provider Demographics
NPI:1619196052
Name:PIATT, TODD STEVEN
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:STEVEN
Last Name:PIATT
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 1:927 EDEN ROC ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1415
Mailing Address - Country:US
Mailing Address - Phone:361-649-8040
Mailing Address - Fax:
Practice Address - Street 1:927 EDEN ROC ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1415
Practice Address - Country:US
Practice Address - Phone:361-649-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2036176225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant