Provider Demographics
NPI:1205828951
Name:HURST, DANIEL LEE (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEE
Last Name:HURST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2898
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3601 4TH ST # MS 9406
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-7335
Practice Address - Fax:806-743-4073
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH00672084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115675101Medicaid
TX115675103OtherFIRSTCARE COMMERCIAL
TX8G6056OtherBCBS
TX118485505Medicaid
NM37127OtherPRESBYTERIAN COMMERCIAL
NMA093OtherTRIWEST
OK100042020AMedicaid
TX118485504Medicaid
TX80939ZOtherHMO BLUE
NMV6663Medicaid
NM37127Medicaid
NM37127Medicaid
TX80939ZOtherHMO BLUE
TX118485504Medicaid