Provider Demographics
NPI:1740392786
Name:HOSEK, HERVE D (MD)
Entity Type:Individual
Prefix:
First Name:HERVE
Middle Name:D
Last Name:HOSEK
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 1:659 CARRIAGE ESTATES RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-4426
Mailing Address - Country:US
Mailing Address - Phone:903-893-1957
Mailing Address - Fax:
Practice Address - Street 1:913 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2831
Practice Address - Country:US
Practice Address - Phone:903-868-9565
Practice Address - Fax:903-893-8916
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4962261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F0758Medicare ID - Type Unspecified
TXC17105Medicare UPIN