Healthcare Provider Details

I. General information

NPI: 1740446426
Provider Name (Legal Business Name): TROY D HUGHES P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4208 RETAMA CIR
VICTORIA TX
77901-2765
US

IV. Provider business mailing address

1501 N. DELEON ST. , SUITE A
VICTORIA TX
77901-5964
US

V. Phone/Fax

Practice location:
  • Phone: 361-582-0611
  • Fax: 361-582-0555
Mailing address:
  • Phone: 361-582-0602
  • Fax: 361-582-0509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number170555
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: