Provider Demographics
NPI:1275921199
Name:ANDY HUGHES, RNFA SURGICAL FIRST ASSIST, LLC
Entity Type:Organization
Organization Name:ANDY HUGHES, RNFA SURGICAL FIRST ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL FIRST ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:PAT
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CNOR, RNFA
Authorized Official - Phone:817-913-4440
Mailing Address - Street 1:6404 STOCKTON DR
Mailing Address - Street 2:P.O. BOX 16160 - FT.WORTH, TX 76162
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-5058
Mailing Address - Country:US
Mailing Address - Phone:817-913-4440
Mailing Address - Fax:
Practice Address - Street 1:6404 STOCKTON DR
Practice Address - Street 2:BOX 16160 - FORT WORTH, TX 76162
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-5058
Practice Address - Country:US
Practice Address - Phone:817-913-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX716498163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty