Provider Demographics
NPI:1174630867
Name:HOGAN, MARGUERITE INEZ (MD)
Entity type:Individual
Prefix:DR
First Name:MARGUERITE
Middle Name:INEZ
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14800 SAN PEDRO AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3734
Mailing Address - Country:US
Mailing Address - Phone:210-490-9850
Mailing Address - Fax:210-490-1465
Practice Address - Street 1:14800 SAN PEDRO AVE STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3734
Practice Address - Country:US
Practice Address - Phone:210-490-9850
Practice Address - Fax:210-490-1465
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL74192084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161536101Medicaid
TX161536101Medicaid
TX8A6627Medicare PIN