Provider Demographics
NPI:1104035187
Name:HODGES, CHARLOTTE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:ANN
Last Name:HODGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:CHARLOTTE
Other - Middle Name:ANN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1151 NORTH BUCKNER BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218
Mailing Address - Country:US
Mailing Address - Phone:214-838-7171
Mailing Address - Fax:214-838-7172
Practice Address - Street 1:1151 NORTH BUCKNER BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218
Practice Address - Country:US
Practice Address - Phone:214-838-7171
Practice Address - Fax:214-838-7172
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9067208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery