Healthcare Provider Details

I. General information

NPI: 1477678308
Provider Name (Legal Business Name): ISELA HURTIG P.A.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/26/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 COUNTY ROAD 300
FALFURRIAS TX
78355-5272
US

IV. Provider business mailing address

3945 INTERSTATE HIGHWAY 69
CORPUS CHRISTI TX
78410
US

V. Phone/Fax

Practice location:
  • Phone: 361-325-7122
  • Fax:
Mailing address:
  • Phone: 361-767-8332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number01462
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA05151
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA05151
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: