Healthcare Provider Details
I. General information
NPI: 1235275777
Provider Name (Legal Business Name): ADELE HOFFMAN HURST PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/30/2007
Last Update Date: 01/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8330 MEADOW RD #126
DALLAS TX
75231-3767
US
IV. Provider business mailing address
8330 MEADOW RD #126
DALLAS TX
75231-3767
US
V. Phone/Fax
- Phone: 214-368-5855
- Fax: 214-368-5855
- Phone: 214-368-5855
- Fax: 214-368-5855
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 24789 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: