Provider Demographics
NPI:1609908201
Name:MITCHELL B. HUGHSTON, M.D. & SUSAN L. REDMOND, M.D., PA
Entity Type:Organization
Organization Name:MITCHELL B. HUGHSTON, M.D. & SUSAN L. REDMOND, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUGHSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-425-8545
Mailing Address - Street 1:1713 TREASURE HILLS BLVD
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8917
Mailing Address - Country:US
Mailing Address - Phone:956-425-8545
Mailing Address - Fax:956-412-0160
Practice Address - Street 1:1713 TREASURE HILLS BLVD
Practice Address - Street 2:SUITE 1D
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8917
Practice Address - Country:US
Practice Address - Phone:956-425-8545
Practice Address - Fax:956-412-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1377207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD87451Medicare UPIN
TXB25834Medicare UPIN