Provider Demographics
NPI:1649372434
Name:HUGGINS, AMY (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-2539
Mailing Address - Country:US
Mailing Address - Phone:936-560-9000
Mailing Address - Fax:936-560-9009
Practice Address - Street 1:3614 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-2539
Practice Address - Country:US
Practice Address - Phone:936-560-9000
Practice Address - Fax:936-560-9009
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4820208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207405603Medicaid
TX207405601Medicaid
TX207405602Medicaid
TX1467787390OtherGROUP NPI
TX180989901Medicaid