Matthew Hicks

Individual provider Active NPI Physical Therapy Assistant · Flint, TX

NPI 1013406545 · NPPES record last updated May 10, 2018

Key facts

NPI
1013406545
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2112883 (TX)
Practice address
18859 Spanish Oak CT
Flint, TX 75762-3430
Phone
(903) 730-0325
NPI assigned
May 10, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2112883TXMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2112883 TX Yes

Addresses

Primary practice location

18859 Spanish Oak CT
Flint, TX 75762-3430

Mailing address

18859 Spanish Oak CT
Flint, TX 75762-3430

Other providers in Flint, TX

All providers in Flint, TX · Physical Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.