Provider Demographics
NPI:1477678308
Name:HURTIG, ISELA (PAC)
Entity Type:Individual
Prefix:
First Name:ISELA
Middle Name:
Last Name:HURTIG
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 S STAPLES ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3113
Mailing Address - Country:US
Mailing Address - Phone:361-694-1498
Mailing Address - Fax:361-694-1499
Practice Address - Street 1:1521 S STAPLES ST STE 300
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3113
Practice Address - Country:US
Practice Address - Phone:361-694-1498
Practice Address - Fax:361-694-1499
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05151363AM0700X, 363A00000X
KS01462363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical