Healthcare Provider Details

I. General information

NPI: 1376925628
Provider Name (Legal Business Name): DONNA HURLBURT OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21703 KINGSLAND BLVD
KATY TX
77450-2520
US

IV. Provider business mailing address

21703 KINGSLAND BLVD
KATY TX
77450-2520
US

V. Phone/Fax

Practice location:
  • Phone: 281-769-1015
  • Fax: 281-717-8947
Mailing address:
  • Phone: 281-769-1015
  • Fax: 281-717-8947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: