Provider Demographics
NPI:1821575259
Name:HOOD, TRENT DAVID (PA)
Entity Type:Individual
Prefix:
First Name:TRENT
Middle Name:DAVID
Last Name:HOOD
Suffix:
Gender:M
Credentials:PA
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 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:903-531-5000
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-593-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX391696704Medicaid
TX8LD210OtherBCBS
TX815619OtherMEDICARE
TX391696702Medicaid
TX8LD200OtherBCBS
TX815831OtherMEDICARE
TX1F9363OtherMEDICARE
TXP02270210OtherMEDICARE RAIL ROAD
TXP02409948OtherMEDICARE RAIL ROAD