Provider Demographics
NPI:1962041772
Name:HUGHES MEDICAL GROUP
Entity Type:Organization
Organization Name:HUGHES MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-622-9252
Mailing Address - Street 1:1501-C S WHEELER
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951
Mailing Address - Country:US
Mailing Address - Phone:409-622-9252
Mailing Address - Fax:409-397-9959
Practice Address - Street 1:1501-C S WHEELER
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951
Practice Address - Country:US
Practice Address - Phone:409-622-9252
Practice Address - Fax:409-397-9959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty