Healthcare Provider Details

I. General information

NPI: 1295842359
Provider Name (Legal Business Name): THELMA HURD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7979 WURZBACH RD
SAN ANTONIO TX
78229-4427
US

IV. Provider business mailing address

7703 FLOYD CURL DRIVE UTHSCSA DEPT. OF SURGERY
SAN ANTONIO TX
78229
US

V. Phone/Fax

Practice location:
  • Phone: 210-257-1400
  • Fax:
Mailing address:
  • Phone: 210-567-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberJ2614
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: