Healthcare Provider Details

I. General information

NPI: 1588478549
Provider Name (Legal Business Name): ANYA HURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2025
Last Update Date: 03/08/2025
Certification Date: 03/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 STOBAUGH ST UNIT B
AUSTIN TX
78757-1527
US

IV. Provider business mailing address

PO BOX 2609
CANYON LAKE TX
78133-0013
US

V. Phone/Fax

Practice location:
  • Phone: 512-993-1737
  • Fax: 512-993-1737
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: