Provider Demographics
NPI:1629350947
Name:HODGSON, MARY CATHERINE (ATP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:HODGSON
Suffix:
Gender:F
Credentials:ATP
Other - Prefix:
Other - First Name:M
Other - Middle Name:CATHY
Other - Last Name:HODGSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATP
Mailing Address - Street 1:1908 GREENFIELD PLZ
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3410
Mailing Address - Country:US
Mailing Address - Phone:979-268-6882
Mailing Address - Fax:979-260-3900
Practice Address - Street 1:1908 GREENFIELD PLZ
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3410
Practice Address - Country:US
Practice Address - Phone:979-268-6882
Practice Address - Fax:979-260-3900
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP45799247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other