Provider Demographics
NPI:1619077807
Name:HURST, COLEEN MERSAIDES (PA)
Entity Type:Individual
Prefix:MRS
First Name:COLEEN
Middle Name:MERSAIDES
Last Name:HURST
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18915 SALADO CYN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-1634
Mailing Address - Country:US
Mailing Address - Phone:210-233-1886
Mailing Address - Fax:
Practice Address - Street 1:20935 US HIGHWAY 281 N
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7587
Practice Address - Country:US
Practice Address - Phone:210-424-0089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant