Provider Demographics
NPI:1093807349
Name:HODGES, RALPH GAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:GAIL
Last Name:HODGES
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:PO BOX 61043
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76906-1043
Mailing Address - Country:US
Mailing Address - Phone:325-949-4545
Mailing Address - Fax:325-942-1482
Practice Address - Street 1:1636 HUNTERS GLEN RD
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-5008
Practice Address - Country:US
Practice Address - Phone:325-949-5722
Practice Address - Fax:325-942-1482
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC63632084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA002OtherCHAMPUS
TX00A755Medicare ID - Type Unspecified
TXA002OtherCHAMPUS