Healthcare Provider Details

I. General information

NPI: 1679084537
Provider Name (Legal Business Name): CHRISTOPHER STEPHEN HEXT PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1642 W AVENUE J
LANCASTER CA
93534-2814
US

IV. Provider business mailing address

41622 FIRENZE ST
LANCASTER CA
93536-2953
US

V. Phone/Fax

Practice location:
  • Phone: 661-942-8463
  • Fax:
Mailing address:
  • Phone: 661-943-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT6414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: