Provider Demographics
NPI:1508126046
Name:HIXON, CHRISTOPHER GLENN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GLENN
Last Name:HIXON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9613 STARFIRE DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8947
Mailing Address - Country:US
Mailing Address - Phone:540-392-0805
Mailing Address - Fax:
Practice Address - Street 1:1790 N STONEBRIDGE DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7437
Practice Address - Country:US
Practice Address - Phone:972-339-0900
Practice Address - Fax:214-491-3777
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ7206207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program