MEDICARE: DR. DAVID BLAKE HODGES M.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	207R00000X	Internal Medicine Physician	BP10034606	TX
2	207RH0003X	Hematology & Oncology Physician	76457	MN
3	207RH0003X	Hematology & Oncology Physician	P1186	TX

General Provider Information

NPI Number	:	1619101896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BLAKE HODGES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 207012
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-7012
Country	:	US
Telephone Number	:	405-682-3303
Fax Number	:	405-384-6793

Provider Business Practice Location Address
First Line	:	21216 NORTHWEST FWY STE 670
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-4697
Country	:	US
Telephone Number	:	254-724-2111
Fax Number	:

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

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	05/31/2024

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