Provider Demographics
NPI:1093762924
Name:HOGUE, ROBERT LANE (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LANE
Last Name:HOGUE
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 1:101 S PARK DR
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5959
Mailing Address - Country:US
Mailing Address - Phone:325-646-6568
Mailing Address - Fax:325-646-9199
Practice Address - Street 1:101 S PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5959
Practice Address - Country:US
Practice Address - Phone:325-646-6568
Practice Address - Fax:325-646-9199
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE-6419207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130813205OtherMEDICAID HEALTHSTEPS
TX130813201Medicaid
TXC-71013Medicare UPIN
TX130813201Medicaid
TX00CM86Medicare ID - Type Unspecified