Provider Demographics
NPI:1013985894
Name:HOYT, STACY LITTLETON (PT)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:LITTLETON
Last Name:HOYT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:DIANNE
Other - Last Name:LITTLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5307 BROADWAY ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5743
Mailing Address - Country:US
Mailing Address - Phone:210-832-5400
Mailing Address - Fax:
Practice Address - Street 1:5307 BROADWAY ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5743
Practice Address - Country:US
Practice Address - Phone:210-832-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1163068225100000X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287015602Medicaid
11669877OtherCAQH
TX873T35OtherBCBSTX
TXP01056511Medicare PIN
TXTXB151780Medicare PIN