Provider Demographics
NPI:1972644466
Name:HODNETT, GEORGE MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:MICHAEL
Last Name:HODNETT
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 1:1651 ROCK PRAIRIE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8652
Mailing Address - Country:US
Mailing Address - Phone:979-693-7400
Mailing Address - Fax:979-693-7450
Practice Address - Street 1:1651 ROCK PRAIRIE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8652
Practice Address - Country:US
Practice Address - Phone:979-693-7400
Practice Address - Fax:979-693-7450
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6357207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187842302Medicaid
TX187842301Medicaid
TX671861Medicare Oscar/Certification