Provider Demographics
NPI:1528100534
Name:MARK D HUGHES DO PA
Entity type:Organization
Organization Name:MARK D HUGHES DO PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:D O P A
Authorized Official - Phone:903-432-2707
Mailing Address - Street 1:606 S SEVEN POINTS DR STE 9
Mailing Address - Street 2:P.O. BOX 43406
Mailing Address - City:SEVEN POINTS
Mailing Address - State:TX
Mailing Address - Zip Code:75143-9117
Mailing Address - Country:US
Mailing Address - Phone:903-432-2707
Mailing Address - Fax:903-432-2709
Practice Address - Street 1:606 S SEVEN POINTS DR
Practice Address - Street 2:SUITE 9
Practice Address - City:SEVEN POINTS
Practice Address - State:TX
Practice Address - Zip Code:75143-9117
Practice Address - Country:US
Practice Address - Phone:903-432-2707
Practice Address - Fax:903-432-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1666261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00436KOtherBLUE CROSS BLUE SHIELD
TX00436KOtherBLUE CROSS BLUE SHIELD
TXA67145Medicare UPIN