Provider Demographics
NPI:1154121101
Name:HILTON POEHL, ALEXIS LEA (LMT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LEA
Last Name:HILTON POEHL
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2376 KENDAL GREEN CIR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4840
Mailing Address - Country:US
Mailing Address - Phone:979-204-4225
Mailing Address - Fax:
Practice Address - Street 1:1748 ROCK PRAIRIE RD STE 8
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5900
Practice Address - Country:US
Practice Address - Phone:979-204-4225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT144441225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist