Healthcare Provider Details

I. General information

NPI: 1083204242
Provider Name (Legal Business Name): JOEL H HURT MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11675 JOLLYVILLE RD STE 207
AUSTIN TX
78759-4105
US

IV. Provider business mailing address

11675 JOLLYVILLE RD STE 207
AUSTIN TX
78759-4105
US

V. Phone/Fax

Practice location:
  • Phone: 512-856-1000
  • Fax: 512-856-4040
Mailing address:
  • Phone: 512-856-1000
  • Fax: 512-856-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: YVONNE POWERS
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 512-856-1000