=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790864494
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUGHES PROFESSIONAL INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 904 W BURLESON ST
-----------------------------------------------------
City | WHARTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77488-5304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-533-4832
-----------------------------------------------------
Fax | 979-532-2895
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 904 W BURLESON ST
-----------------------------------------------------
City | WHARTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77488-5304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-533-4832
-----------------------------------------------------
Fax | 979-532-2895
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ADMINISTRATOR
-----------------------------------------------------
Name | LINDA LATHON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 979-533-4832
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------