MEDICARE: ASHLEY HOGAN

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	363LF0000X	Family Nurse Practitioner	AP139520	TX

General Provider Information

NPI Number	:	1871051680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY HOGAN

Provider Business Mailing Address
First Line	:	3602 MATLOCK RD STE 206
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-3600
Country	:	US
Telephone Number	:	210-777-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	1152 RICHARD PITTMON DR
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-1226
Country	:	US
Telephone Number	:	817-437-8716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2019
Last Update Date	:	03/31/2026

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Directions to “ ASHLEY HOGAN ” Practice Location

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