Provider Demographics
NPI:1043546310
Name:HUTTON OB GYN PLLC
Entity Type:Organization
Organization Name:HUTTON OB GYN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED CODER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:CMC
Authorized Official - Phone:281-412-0403
Mailing Address - Street 1:2260 W HOLCOMBE BLVD
Mailing Address - Street 2:SUITE 253
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2008
Mailing Address - Country:US
Mailing Address - Phone:281-772-7861
Mailing Address - Fax:
Practice Address - Street 1:2260 W. HOLCOMBE BLVD.
Practice Address - Street 2:STE. 253
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:281-772-7561
Practice Address - Fax:281-817-7549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3893207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH22621Medicare UPIN