Provider Demographics
NPI:1417201732
Name:HODGES, NIKI (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:NIKI
Middle Name:
Last Name:HODGES
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13230 FM 1764 RD STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77510-9132
Mailing Address - Country:US
Mailing Address - Phone:409-316-9085
Mailing Address - Fax:
Practice Address - Street 1:14310 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:TX
Practice Address - Zip Code:77517-3421
Practice Address - Country:US
Practice Address - Phone:409-316-9085
Practice Address - Fax:409-316-9014
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty