Provider Demographics
NPI:1790002368
Name:HUGHES, JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
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 1:14841 DALLAS PKWY
Mailing Address - Street 2:SUITE 440
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7685
Mailing Address - Country:US
Mailing Address - Phone:214-854-3124
Mailing Address - Fax:214-854-3133
Practice Address - Street 1:14841 DALLAS PKWY
Practice Address - Street 2:SUITE 440
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7685
Practice Address - Country:US
Practice Address - Phone:214-854-3124
Practice Address - Fax:214-854-3133
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7784207L00000X
IL125056338390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program