Provider Demographics
NPI:1154440469
Name:HUGHES, SUSAN C (OT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:HUGHES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4031 W PLANO PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5619
Mailing Address - Country:US
Mailing Address - Phone:972-596-1715
Mailing Address - Fax:972-867-9726
Practice Address - Street 1:4031 W PLANO PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5619
Practice Address - Country:US
Practice Address - Phone:972-596-1715
Practice Address - Fax:972-867-9726
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100724225X00000X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB156255Medicare PIN