Provider Demographics
NPI:1366649147
Name:HUGHES, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 MUELLER BLVD
Mailing Address - Street 2:DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3079
Mailing Address - Country:US
Mailing Address - Phone:512-324-0164
Mailing Address - Fax:512-324-0786
Practice Address - Street 1:4900 MUELLER BLVD
Practice Address - Street 2:DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:512-324-0164
Practice Address - Fax:512-324-0786
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA95590208000000X
TXN0195208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L1210OtherMEDICARE
TX197181901Medicaid