Provider Demographics
NPI:1952303984
Name:HUDGENS, MARK F (RPH)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:F
Last Name:HUDGENS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6104 AVENUE Q SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412-3700
Mailing Address - Country:US
Mailing Address - Phone:806-472-3455
Mailing Address - Fax:
Practice Address - Street 1:6104 AVENUE Q SOUTH DR
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-3700
Practice Address - Country:US
Practice Address - Phone:806-472-3455
Practice Address - Fax:806-472-3401
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35481183500000X
OK11963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist