Provider Demographics
NPI:1033712237
Name:HODGES, BARRY BRENT
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:BRENT
Last Name:HODGES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13829 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3533
Mailing Address - Country:US
Mailing Address - Phone:281-491-7551
Mailing Address - Fax:
Practice Address - Street 1:13829 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3533
Practice Address - Country:US
Practice Address - Phone:281-491-7551
Practice Address - Fax:281-491-1190
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist