Provider Demographics
NPI:1104195213
Name:HUGHES, LAUREN M (PA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10061 CHAMBER HALL DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1226
Mailing Address - Country:US
Mailing Address - Phone:972-743-0006
Mailing Address - Fax:
Practice Address - Street 1:5044 TENNYSON PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2952
Practice Address - Country:US
Practice Address - Phone:972-985-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07649363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX297396801Medicaid
TXTXB151963Medicare PIN