Healthcare Provider Details
I. General information
NPI: 1922219351
Provider Name (Legal Business Name): MR. A.B. HURD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4420 W. OREM SUITE B
HOUSTON TX
77045
US
IV. Provider business mailing address
4420 W. OREM SUITE B
HOUSTON TX
77045
US
V. Phone/Fax
- Phone: 713-433-5656
- Fax: 713-433-6653
- Phone: 713-433-5656
- Fax: 713-433-6653
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 19511 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: