=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740446426
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TROY D HUGHES P.T.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2008
-----------------------------------------------------
Last Update Date | 08/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4208 RETAMA CIR
-----------------------------------------------------
City | VICTORIA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77901-2765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-582-0611
-----------------------------------------------------
Fax | 361-582-0555
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1501 N. DELEON ST. , SUITE A
-----------------------------------------------------
City | VICTORIA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77901-5964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-582-0602
-----------------------------------------------------
Fax | 361-582-0509
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 170555
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------