Provider Demographics
NPI:1518933365
Name:HUGHES, MARLON (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLON
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5500
Mailing Address - Street 2:SUITE 620
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79704-5500
Mailing Address - Country:US
Mailing Address - Phone:432-570-1421
Mailing Address - Fax:432-570-1427
Practice Address - Street 1:2200 W ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6407
Practice Address - Country:US
Practice Address - Phone:432-570-1421
Practice Address - Fax:432-570-1427
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ82762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132330507OtherDIA CHCSN PROV#
TX81757ROtherSWMI BCBSTX PROV#
TX132330504Medicaid
TX86R225OtherDIA BCBSTX PROV#
TX132330502Medicaid
TX132330503OtherSWMI CHCSN PROV#
TX83R225Medicare ID - Type UnspecifiedDIA MCARE PROV#
TX132330502Medicaid
TX81757ROtherSWMI BCBSTX PROV#
TX132330507OtherDIA CHCSN PROV#
TX81757RMedicare ID - Type UnspecifiedSWMI MCARE PROV#