Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2035004 | TX |
NPI | 1013295302 |
---|---|
Provider Name | Anthony Hurt |
First Address | Irving, TX 75061-2221 |
Second Address | Irving, TX 75061-2221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2011 |
Last Update Date | 03/08/2011 |