Healthcare Provider Details
I. General information
NPI: 1912985193
Provider Name (Legal Business Name): PAUL HURST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/06/2006
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
215 N NEW RIVER DR E APT 950
FORT LAUDERDALE FL
33301-1075
US
IV. Provider business mailing address
501 MIDWESTERN PKWY E
WICHITA FALLS TX
76302-2302
US
V. Phone/Fax
- Phone: 940-642-8162
- Fax: 864-516-7838
- Phone: 940-766-3551
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | L6949 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | ME142425 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: