MEDICARE: MR. MARVIN EDSON HUGHES III

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	10877	TX
2	101YP2500X	Professional Counselor	10877	TX

General Provider Information

NPI Number	:	1104590322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARVIN EDSON HUGHES III

Provider Business Mailing Address
First Line	:	3121 BUFFALO SPEEDWAY APT 6204
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1854
Country	:	US
Telephone Number	:	713-208-8837
Fax Number	:

Provider Business Practice Location Address
First Line	:	3121 BUFFALO SPEEDWAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1971
Country	:	US
Telephone Number	:	713-208-8837
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	07/16/2025

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