Provider Demographics
NPI:1003626987
Name:HINTON, ZYKEITH T
Entity type:Individual
Prefix:
First Name:ZYKEITH
Middle Name:T
Last Name:HINTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 FORT WORTH AVE APT 3119
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-0289
Mailing Address - Country:US
Mailing Address - Phone:205-799-2975
Mailing Address - Fax:
Practice Address - Street 1:3500 OAK LAWN AVE STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-6714
Practice Address - Country:US
Practice Address - Phone:214-385-5445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97279101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty