Healthcare Provider Details

I. General information

NPI: 1598731309
Provider Name (Legal Business Name): EDWARD J HURWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 03/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 WILLIAMS TRACE BLVD SUITE 112
SUGAR LAND TX
77478-4513
US

IV. Provider business mailing address

7515 MAIN ST SUITE 770
HOUSTON TX
77030-4519
US

V. Phone/Fax

Practice location:
  • Phone: 281-313-0006
  • Fax: 281-265-3393
Mailing address:
  • Phone: 719-797-6171
  • Fax: 713-797-6669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD3277
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: