Provider Demographics
NPI:1508996703
Name:LARRY HUGHES, D.O., P.A.
Entity Type:Organization
Organization Name:LARRY HUGHES, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:254-729-8910
Mailing Address - Street 1:593 LCR 404
Mailing Address - Street 2:
Mailing Address - City:GROESBECK
Mailing Address - State:TX
Mailing Address - Zip Code:76642-2663
Mailing Address - Country:US
Mailing Address - Phone:254-729-8910
Mailing Address - Fax:254-729-8114
Practice Address - Street 1:593 LCR 404
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642-2663
Practice Address - Country:US
Practice Address - Phone:254-729-8910
Practice Address - Fax:254-729-8114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherCOMMERCIAL CLAIMS
TX=========OtherCOMMERCIAL CLAIMS