Provider Demographics
NPI:1255422382
Name:HUGHES, JOHNNIE G (DC)
Entity type:Individual
Prefix:
First Name:JOHNNIE
Middle Name:G
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6708 BLUFFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3063
Mailing Address - Country:US
Mailing Address - Phone:817-733-2604
Mailing Address - Fax:
Practice Address - Street 1:5750 RUFE SNOW DR
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6163
Practice Address - Country:US
Practice Address - Phone:817-220-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0186UOtherBCBSNC GROUP NUMBER
NC0842EOtherBCBSNC
NC890842EMedicaid
NC890186UMedicaid
NC2453940Medicare ID - Type UnspecifiedGROUP NUMBER
NC0842EOtherBCBSNC
NC890842EMedicaid