Provider Demographics
NPI:1366268807
Name:HENDRIX, DAKVIN CORTEZ (CTRS)
Entity type:Individual
Prefix:
First Name:DAKVIN
Middle Name:CORTEZ
Last Name:HENDRIX
Suffix:
Gender:M
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 FALCON LANDING BLVD APT 2306
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7751
Mailing Address - Country:US
Mailing Address - Phone:346-538-3818
Mailing Address - Fax:
Practice Address - Street 1:3300 FALCON LANDING BLVD APT 2306
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7751
Practice Address - Country:US
Practice Address - Phone:346-538-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-30
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1418225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty