Provider Demographics
NPI:1508970054
Name:HODGES, ANN M (PSYD)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:HODGES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9525 KATY FWY STE 210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1432
Mailing Address - Country:US
Mailing Address - Phone:713-465-7280
Mailing Address - Fax:713-468-2868
Practice Address - Street 1:9525 KATY FWY STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1432
Practice Address - Country:US
Practice Address - Phone:713-465-7280
Practice Address - Fax:713-468-2868
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23777103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00F63CMedicare ID - Type UnspecifiedMEDICARE