Provider Demographics
NPI:1306044805
Name:HUDGINS, ANGIE N (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGIE
Middle Name:N
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:N
Other - Last Name:SCRIPTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4951 LONG PRAIRIE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2709
Mailing Address - Country:US
Mailing Address - Phone:972-691-9190
Mailing Address - Fax:972-691-3841
Practice Address - Street 1:4951 LONG PRAIRIE RD STE 120
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2709
Practice Address - Country:US
Practice Address - Phone:972-691-9190
Practice Address - Fax:972-691-3841
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
AK1077662363A00000X
TXPA07814363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No171000000XOther Service ProvidersMilitary Health Care Provider