MEDICARE: MS. ANN M HODGES PSY.D

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	103TC0700X	Clinical Psychologist	23777	TX

General Provider Information

NPI Number	:	1508970054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN M HODGES PSY.D

Provider Business Mailing Address
First Line	:	9525 KATY FWY STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1432
Country	:	US
Telephone Number	:	713-465-7280
Fax Number	:	713-468-2868

Provider Business Practice Location Address
First Line	:	9525 KATY FWY STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1432
Country	:	US
Telephone Number	:	713-465-7280
Fax Number	:	713-468-2868

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

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/09/2007

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