Provider Demographics
NPI:1124153010
Name:HICKS, CHRISTOPHER AARON (PT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:AARON
Last Name:HICKS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 HALSELL ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:TX
Mailing Address - Zip Code:76426-3000
Mailing Address - Country:US
Mailing Address - Phone:940-683-5575
Mailing Address - Fax:866-210-0568
Practice Address - Street 1:1116 HALSELL ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:TX
Practice Address - Zip Code:76426-3000
Practice Address - Country:US
Practice Address - Phone:940-683-5575
Practice Address - Fax:866-210-0568
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist