Provider Demographics
NPI:1326039215
Name:HUGHES, CHARLECE (DO)
Entity Type:Individual
Prefix:MRS
First Name:CHARLECE
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 8TH AVE
Mailing Address - Street 2:#408
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4137
Mailing Address - Country:US
Mailing Address - Phone:817-921-4191
Mailing Address - Fax:817-429-7783
Practice Address - Street 1:1307 8TH AVE
Practice Address - Street 2:#408
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4137
Practice Address - Country:US
Practice Address - Phone:817-921-4191
Practice Address - Fax:817-429-7783
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00695072084N0400X
TXL57732084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI43890Medicare UPIN