Healthcare Provider Details

I. General information

NPI: 1407282783
Provider Name (Legal Business Name): BAYLIE MARIE HURT D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8050 E HIGHWAY 191 STE 202
ODESSA TX
79765-8615
US

IV. Provider business mailing address

PO BOX 700688
SAN ANTONIO TX
78270-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-404-6050
  • Fax: 866-313-3397
Mailing address:
  • Phone: 210-318-3007
  • Fax: 210-468-0682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number12399
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: