Provider Demographics
NPI:1689841090
Name:KENT HUGHES, M.D., P.A.
Entity type:Organization
Organization Name:KENT HUGHES, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-645-4900
Mailing Address - Street 1:203 WALLS DR
Mailing Address - Street 2:SUITE 103A
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7022
Mailing Address - Country:US
Mailing Address - Phone:817-645-4900
Mailing Address - Fax:817-645-9974
Practice Address - Street 1:203 WALLS DR
Practice Address - Street 2:SUITE 103A
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-7022
Practice Address - Country:US
Practice Address - Phone:817-645-4900
Practice Address - Fax:817-645-9974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0967302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization