Provider Demographics
NPI:1598954877
Name:CALHOUN, LEXIE DAWN (LPTA)
Entity Type:Individual
Prefix:
First Name:LEXIE
Middle Name:DAWN
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 HEMPSTEAD 5
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8906
Mailing Address - Country:US
Mailing Address - Phone:870-703-6493
Mailing Address - Fax:870-777-6721
Practice Address - Street 1:500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-5206
Practice Address - Country:US
Practice Address - Phone:870-777-4501
Practice Address - Fax:870-777-6721
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA 2190225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR165062721Medicaid