Provider Demographics
NPI:1972588275
Name:HUGHES, JENEVIEVE H (MD)
Entity Type:Individual
Prefix:DR
First Name:JENEVIEVE
Middle Name:H
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 W CAMPBELL RD
Mailing Address - Street 2:SUITE 206A
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3595
Mailing Address - Country:US
Mailing Address - Phone:972-498-4143
Mailing Address - Fax:972-498-8228
Practice Address - Street 1:2805 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3561
Practice Address - Country:US
Practice Address - Phone:469-204-6230
Practice Address - Fax:469-204-6239
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31933208600000X
TXM8721208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01294343OtherRAILROAD MEDICARE
AZ806549Medicaid
AZ86080015085259A893OtherTRIWEST
H95897Medicare UPIN
TX8L17615Medicare PIN
TXP01294343OtherRAILROAD MEDICARE