Provider Demographics
NPI:1467699140
Name:HOGAN, JOLINDA ANNA
Entity Type:Individual
Prefix:MRS
First Name:JOLINDA
Middle Name:ANNA
Last Name:HOGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-5054
Mailing Address - Country:US
Mailing Address - Phone:903-819-2875
Mailing Address - Fax:903-487-2240
Practice Address - Street 1:1000 N TRAVIS ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-5054
Practice Address - Country:US
Practice Address - Phone:903-819-2875
Practice Address - Fax:903-487-2240
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier