Provider Demographics
NPI:1891970497
Name:HODGKINSON PC
Entity Type:Organization
Organization Name:HODGKINSON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CREAGER
Authorized Official - Last Name:HODGKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:361-582-4667
Mailing Address - Street 1:2806 N NAVARRO ST
Mailing Address - Street 2:SUITE K
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3918
Mailing Address - Country:US
Mailing Address - Phone:361-582-4667
Mailing Address - Fax:361-582-4787
Practice Address - Street 1:2806 N NAVARRO ST
Practice Address - Street 2:SUITE K
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3918
Practice Address - Country:US
Practice Address - Phone:361-582-4667
Practice Address - Fax:361-582-4787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621270000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4411879OtherAETNA
TX108039202Medicaid
TX82454TOtherBLUE CROSS BLUE SHIELD
TX4411879OtherAETNA