Healthcare Provider Details

I. General information

NPI: 1700833308
Provider Name (Legal Business Name): JODIE L HURWITZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 01/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 COIT RD STE 308
PLANO TX
75075-6173
US

IV. Provider business mailing address

8440 WALNUT HILL LN SUITE 700
DALLAS TX
75231-3833
US

V. Phone/Fax

Practice location:
  • Phone: 214-361-3300
  • Fax:
Mailing address:
  • Phone: 214-361-3300
  • Fax: 214-361-3431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberG25443
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: