1528389558 NPI number — MRS. CRISTINA MARIE HODGKISS FNP

Table of content: MRS. CRISTINA MARIE HODGKISS FNP (NPI 1528389558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528389558 NPI number — MRS. CRISTINA MARIE HODGKISS FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HODGKISS
Provider First Name:
CRISTINA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528389558
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7800 SHOAL CREEK BLVD
Provider Second Line Business Mailing Address:
SUITE 205N
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78757-1098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-206-4341
Provider Business Mailing Address Fax Number:
512-407-1947

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3801 N LAMAR BLVD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78756-4080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-206-3600
Provider Business Practice Location Address Fax Number:
512-206-3604
Provider Enumeration Date:
06/14/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  705716 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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