Healthcare Provider Details

I. General information

NPI: 1972769636
Provider Name (Legal Business Name): MICHELE HURLEY M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10565 VINEMONT ST
DALLAS TX
75218-2353
US

IV. Provider business mailing address

10570 SE WASHINGTON ST STE. 202
PORTLAND OR
97216-2846
US

V. Phone/Fax

Practice location:
  • Phone: 214-557-6727
  • Fax: 214-324-1301
Mailing address:
  • Phone: 214-557-6727
  • Fax: 214-324-1301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number50708
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: