Provider Demographics
NPI:1699653790
Name:HODGE, GRADY
Entity type:Individual
Prefix:
First Name:GRADY
Middle Name:
Last Name:HODGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 BRITTMOORE RD STE 8400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2244
Mailing Address - Country:US
Mailing Address - Phone:713-832-9971
Mailing Address - Fax:
Practice Address - Street 1:2121 BRITTMOORE RD STE 8400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-2244
Practice Address - Country:US
Practice Address - Phone:713-832-9971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies