Provider Demographics
NPI:1942735360
Name:PUGH, GEORGE-THOMAS MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE-THOMAS
Middle Name:MARTIN
Last Name:PUGH
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 1:11503 NW MILITARY HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1895
Mailing Address - Country:US
Mailing Address - Phone:210-233-6363
Mailing Address - Fax:
Practice Address - Street 1:7700 FLOYD CURL DR STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3902
Practice Address - Country:US
Practice Address - Phone:210-233-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-23
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK33974207P00000X
IN01085996A207P00000X
LA334003207P00000X
390200000X
TXT9775207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program