Provider Demographics
NPI:1205468303
Name:BADEAUX, CHRISTYNA (PT)
Entity type:Individual
Prefix:
First Name:CHRISTYNA
Middle Name:
Last Name:BADEAUX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SANGER AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5866
Mailing Address - Country:US
Mailing Address - Phone:254-848-6284
Mailing Address - Fax:
Practice Address - Street 1:500 SOUTH ST UNIT 300
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-6183
Practice Address - Country:US
Practice Address - Phone:254-644-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist