Provider Demographics
NPI:1750792495
Name:HUGHES, MARCUS (MT-BC)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77378-8827
Mailing Address - Country:US
Mailing Address - Phone:281-624-6822
Mailing Address - Fax:
Practice Address - Street 1:7365 TEASWOOD DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-5401
Practice Address - Country:US
Practice Address - Phone:281-624-6822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11121225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist