Healthcare Provider Details

I. General information

NPI: 1407543622
Provider Name (Legal Business Name): SEXTON INNOVATIONS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1918 WAKE FOREST DR
DEER PARK TX
77536-4612
US

IV. Provider business mailing address

1918 WAKE FOREST DR
DEER PARK TX
77536-4612
US

V. Phone/Fax

Practice location:
  • Phone: 832-556-9448
  • Fax:
Mailing address:
  • Phone: 832-556-9448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN SEXTON
Title or Position: PRESIDENT
Credential:
Phone: 832-556-9448