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General NPI Number Information
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NPI Number | 1710526314
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Entity Type | Organization
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Legal Business Name | PLATINUM PERFORMANCE THERAPY, PLLC
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Dates
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Enumeration Date | 12/30/2019
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Last Update Date | 12/30/2019
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Provider Practice Location Address
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Address Line | 718 W DAVIS ST
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City | DALLAS
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State | TX
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Zip | 75208-4951
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Country | US
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Telephone | 469-930-0021
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Fax | 214-613-1462
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Provider Business Mailing Address
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Address Line | 718 W DAVIS ST
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City | DALLAS
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State | TX
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Zip | 75208-4951
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Country | US
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Telephone | 469-930-0021
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Fax | 214-613-1462
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | ALEJANDRO A SAENZ
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Credential | MPT
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Telephone | 469-930-0021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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