MEDICARE: APRIL L HURST PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 2933	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	98359	OTHER	AR	BLUE CROSS

General Provider Information

NPI Number	:	1386638914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APRIL L HURST PT

Provider Business Mailing Address
First Line	:	PO BOX 3070
Second Line	:
City	:	TEXARKANA
State	:	TX
Zip	:	75504-3070
Country	:	US
Telephone Number	:	903-735-5357
Fax Number	:	903-735-5399

Provider Business Practice Location Address
First Line	:	1425 LINCOLN RD
Second Line	:	SUITE B-3
City	:	IDABEL
State	:	OK
Zip	:	74745-7345
Country	:	US
Telephone Number	:	580-286-4842
Fax Number	:	903-735-5399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	07/08/2007

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Directions to “ APRIL L HURST PT” Practice Location

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