Provider Demographics
NPI:1558315598
Name:HOGAN, PATRICK JEREMIAH (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JEREMIAH
Last Name:HOGAN
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 1:6624 FANNIN ST
Mailing Address - Street 2:SUITE 2220
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2334
Mailing Address - Country:US
Mailing Address - Phone:713-791-9400
Mailing Address - Fax:713-795-5651
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:SUITE 2220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2334
Practice Address - Country:US
Practice Address - Phone:713-791-9400
Practice Address - Fax:713-795-5651
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1615207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129293002Medicaid
MO204880108Medicaid
LA1199915Medicaid
FL900741500Medicaid
TX874221OtherBLUE CROSS BLUE SHIELD
MO204880108Medicaid
FL900741500Medicaid