Provider Demographics
NPI: | 1013021484 |
---|---|
Name: | HUGHES, WILLIAM HOWARD (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | WILLIAM |
Middle Name: | HOWARD |
Last Name: | HUGHES |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 714 HIGH POINT DR |
Mailing Address - Street 2: | |
Mailing Address - City: | PRINCETON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75407-2571 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 916-838-8682 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 400 N ALLEN DR STE 103 |
Practice Address - Street 2: | |
Practice Address - City: | ALLEN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75013-2564 |
Practice Address - Country: | US |
Practice Address - Phone: | 469-795-1074 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-08-19 |
Last Update Date: | 2021-06-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A53892 | 2084P0800X |
TX | S3912 | 2084P0804X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 4073028 | Medicaid | |
CA | F97432 | Medicare UPIN | |
CA | 4073028 | Medicaid |