Provider Demographics
NPI:1902912819
Name:HUGHES, CRAIG C (OD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:C
Last Name:HUGHES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 MID CITIES BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2748
Mailing Address - Country:US
Mailing Address - Phone:817-656-2020
Mailing Address - Fax:817-656-5908
Practice Address - Street 1:750 MID CITIES BLVD STE A
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2792
Practice Address - Country:US
Practice Address - Phone:817-656-2020
Practice Address - Fax:817-656-5908
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2130TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX410045333Medicare PIN
TX83491EMedicare PIN
TXT13964Medicare UPIN