Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1163068 | TX |
N | 2251S0007X | Physical Therapist - Sports | 1163068 | TX |
NPI | 1013985894 |
---|---|
Provider Name | Stacy Littleton Hoyt |
First Address | San Antonio, TX 78209-5743 |
Second Address | San Antonio, TX 78209-5743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11669877 | CAQH (01) | |
287015602 | (05) | TX |
873T35 | BCBSTX (01) | TX |