Healthcare Provider Details

I. General information

NPI: 1447817135
Provider Name (Legal Business Name): ANDREA HURLEY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1724 RICHMOND AVE
HOUSTON TX
77098-3604
US

IV. Provider business mailing address

15602 MIRA MONTE DR
HOUSTON TX
77083-4016
US

V. Phone/Fax

Practice location:
  • Phone: 832-685-2222
  • Fax:
Mailing address:
  • Phone: 281-780-4284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP141628
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: