Provider Demographics
NPI:1629257456
Name:HURST, BARBARA A (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:HURST
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 N VELASCO ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-3179
Mailing Address - Country:US
Mailing Address - Phone:979-549-0955
Mailing Address - Fax:979-848-8091
Practice Address - Street 1:2512 N VELASCO ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3179
Practice Address - Country:US
Practice Address - Phone:979-549-0955
Practice Address - Fax:979-848-8091
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20063101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20063OtherLPC
TX178508101Medicaid
TX2006007395OtherDBA