Provider Demographics
NPI:1477713535
Name:HURST, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:HURST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4700 SETON CENTER PKWY
Mailing Address - Street 2:STE 115
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5753
Mailing Address - Country:US
Mailing Address - Phone:936-305-5301
Mailing Address - Fax:936-305-5362
Practice Address - Street 1:3816 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-2011
Practice Address - Country:US
Practice Address - Phone:936-305-5301
Practice Address - Fax:936-249-0010
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6426207X00000X
KS04-37030207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201097410AMedicaid
1477713535OtherNPI
KS201097410AMedicaid