1033120423 NPI number — TEXAS HEALTH HUGULEY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033120423 NPI number — TEXAS HEALTH HUGULEY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS HEALTH HUGULEY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1033120423
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6337
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76115-0337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-551-2740
Provider Business Mailing Address Fax Number:
817-568-1296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11801 SOUTH FWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURLESON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76028-7021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-551-2740
Provider Business Practice Location Address Fax Number:
817-568-1296
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
PENNY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
817-551-2704

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  100157 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 100157 , 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)

  • Identifier: 15515001 . This is a "PACIFICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 450677 . This is a "STERLING" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: HH0732 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 58290 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 18147 . This is a "SCOTT & WHITE HEALTH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 450677 . This is a "UNICARE PPO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: HH3237 . This is a "BCBS CD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: HH6510 . This is a "BCBS PHP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 314080801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 131205 . This is a "VALUE BEHAVIORAL HEALTH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 237219332 . This is a "CHAMPUS/VA/TRICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 104123100 . This is a "FIRST HEALTH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 314080802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6541690 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com