Individual
CHARLES VON ODEN HUGHES III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
116A JOHN DUPRE DR, LEVELLAND, TX 79336
(806) 894-7900
Mailing address
116A JOHN DUPRE DR, LEVELLAND, TX 79336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G2997
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115591104
FIRSTCARE
TX
01
—
119658
SUPERIOR HEALTH PLAN
TX
05
—
130236601
—
TX
01
—
5086025
AETNA
—
01
—
MDG2997
WORKERS COMP
TX
Enumeration date
10/13/2005
Last updated
07/13/2007
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