Healthcare Provider Details

I. General information

NPI: 1710298120
Provider Name (Legal Business Name): LEAH HURST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 S VOSS RD
HOUSTON TX
77057-1088
US

IV. Provider business mailing address

3663 BRIARPARK DR
HOUSTON TX
77042-5205
US

V. Phone/Fax

Practice location:
  • Phone: 713-783-1083
  • Fax: 713-975-3956
Mailing address:
  • Phone: 713-268-3630
  • Fax: 623-869-1717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number44359
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: