MEDICARE: HODGKINSON PC

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	261QP2000X	Physical Therapy Clinic/Center	621270000	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4411879	OTHER	TX	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	82454T	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1891970497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HODGKINSON PC

Provider Business Mailing Address
First Line	:	2806 N NAVARRO ST
Second Line	:	SUITE K
City	:	VICTORIA
State	:	TX
Zip	:	77901-3918
Country	:	US
Telephone Number	:	361-582-4667
Fax Number	:	361-582-4787

Provider Business Practice Location Address
First Line	:	2806 N NAVARRO ST
Second Line	:	SUITE K
City	:	VICTORIA
State	:	TX
Zip	:	77901-3918
Country	:	US
Telephone Number	:	361-582-4667
Fax Number	:	361-582-4787

Authorized Official
Title or Position	:	PRESIDENT/PHYSICAL THERAPIST
Name	:	MS. MARY CREAGER HODGKINSON
Credential	:	PT
Telephone Number	:	361-582-4667

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	01/02/2008

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Directions to “HODGKINSON PC ” Practice Location

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