Provider Demographics
NPI:1932566791
Name:MATTOX, CHRISTY (COTA)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:MATTOX
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CIVIC CIR STE 250
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3648
Mailing Address - Country:US
Mailing Address - Phone:972-219-1200
Mailing Address - Fax:
Practice Address - Street 1:190 CIVIC CIR STE 250
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3648
Practice Address - Country:US
Practice Address - Phone:972-219-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant