Healthcare Provider Details

I. General information

NPI: 1306515192
Provider Name (Legal Business Name): TREVOR WAYNE HURTIG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 SAINT JAMES PL STE 210
HOUSTON TX
77056-3432
US

IV. Provider business mailing address

3675 SUMMER AVE
MEMPHIS TN
38122-3742
US

V. Phone/Fax

Practice location:
  • Phone: 713-622-3300
  • Fax: 281-476-6134
Mailing address:
  • Phone: 901-323-3613
  • Fax: 901-454-5939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3478
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15539
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: