Basic Information
Provider Information
NPI: 1194492843
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUGHES
FirstName: RYAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 N OKLAHOMA AVE APT 2124
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731044420
CountryCode: US
TelephoneNumber: 9094864283
FaxNumber:  
Practice Location
Address1: 2401 NW 23RD ST STE 2D
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731072420
CountryCode: US
TelephoneNumber: 4053553239
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/29/2021
LastUpdateDate: 08/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XCF390OKY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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