Healthcare Provider Details

I. General information

NPI: 1225033210
Provider Name (Legal Business Name): MARK D HUGHES D O P A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 S SEVEN POINTS DR STE 9
SEVEN POINTS TX
75143-9117
US

IV. Provider business mailing address

PO BOX 43406
SEVEN POINTS TX
75143-8504
US

V. Phone/Fax

Practice location:
  • Phone: 903-432-2707
  • Fax:
Mailing address:
  • Phone: 903-432-2707
  • Fax: 903-432-2709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberF1666
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF1666
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: