Provider Demographics
NPI:1841768447
Name:SMITH, ALINA NICHOLE (DPT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:ALINA
Middle Name:NICHOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 BILTMORE LOOP
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-1798
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:TEXAS CHILDREN'S HOSPITAL - THE WOODLANDS
Practice Address - Street 2:17580 INTERSTATE 45 SOUTH
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:936-267-7309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1222250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist