=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669567178
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRAIG A HURWITZ MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 04/08/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4900 MUELLER BLVD PALLIATIVE CARE DEPARTMENT
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78723-3079
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-324-0197
-----------------------------------------------------
Fax | 512-324-0780
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1301 BARBARA JORDAN BLVD SUITE #200
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78723-3077
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-628-1932
-----------------------------------------------------
Fax | 512-628-1801
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080H0002X
-----------------------------------------------------
Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
-----------------------------------------------------
License Number | G3489
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------