Provider Demographics
NPI:1912006792
Name:HAGAR, KRISTY SCOTT (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:SCOTT
Last Name:HAGAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 HALL JOHNSON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7810
Mailing Address - Country:US
Mailing Address - Phone:214-649-9207
Mailing Address - Fax:817-428-9885
Practice Address - Street 1:1215 HALL JOHNSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7810
Practice Address - Country:US
Practice Address - Phone:214-649-9207
Practice Address - Fax:817-428-9885
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31884103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist