Provider Demographics
NPI:1518323146
Name:HUGHEY, JORDAN (PA-C, MPAS)
Entity Type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:
Last Name:HUGHEY
Suffix:
Gender:M
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 WALNUT HILL LN STE 320
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4481
Mailing Address - Country:US
Mailing Address - Phone:214-369-5432
Mailing Address - Fax:214-369-5591
Practice Address - Street 1:8230 WALNUT HILL LN STE 320
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4481
Practice Address - Country:US
Practice Address - Phone:214-369-5432
Practice Address - Fax:214-369-5591
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TXPA10402363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant