Healthcare Provider Details

I. General information

NPI: 1336112739
Provider Name (Legal Business Name): JERALD L. HURT P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JERRY HURT P.T.

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 TREMONT ST
GALVESTON TX
77550-7904
US

IV. Provider business mailing address

1810 TREMONT ST
GALVESTON TX
77550-7904
US

V. Phone/Fax

Practice location:
  • Phone: 409-763-7025
  • Fax: 409-763-8648
Mailing address:
  • Phone: 409-763-7025
  • Fax: 409-763-8648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1015105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: