Provider Demographics
NPI:1811976715
Name:MCHUGH, RYAN C (MD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:C
Last Name:MCHUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WINNIE
Mailing Address - State:TX
Mailing Address - Zip Code:77665-7600
Mailing Address - Country:US
Mailing Address - Phone:409-296-6000
Mailing Address - Fax:409-396-6372
Practice Address - Street 1:2400 HIGHWAY 365 STE 208
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6250
Practice Address - Country:US
Practice Address - Phone:409-724-7904
Practice Address - Fax:409-226-3374
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2493207L00000X, 207LP2900X, 208VP0014X
MN47724207L00000X
MS20361207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN337162000Medicaid
MN050001888Medicare ID - Type Unspecified
MN337162000Medicaid