1609908201 NPI number — MITCHELL B. HUGHSTON, M.D. & SUSAN L. REDMOND, M.D., PA

Table of content: (NPI 1609908201)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609908201 NPI number — MITCHELL B. HUGHSTON, M.D. & SUSAN L. REDMOND, M.D., PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MITCHELL B. HUGHSTON, M.D. & SUSAN L. REDMOND, M.D., PA
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:
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:
1609908201
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1713 TREASURE HILLS BLVD
Provider Second Line Business Mailing Address:
SUITE 1D
Provider Business Mailing Address City Name:
HARLINGEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78550-8917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-425-8545
Provider Business Mailing Address Fax Number:
956-412-0160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1713 TREASURE HILLS BLVD
Provider Second Line Business Practice Location Address:
SUITE 1D
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-8917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-425-8545
Provider Business Practice Location Address Fax Number:
956-412-0160
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HUGHSTON
Authorized Official First Name:
MITCHELL
Authorized Official Middle Name:
B
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
956-425-8545

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  H1377 , 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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