Provider Demographics
NPI:1770640948
Name:KRISTINA P HURSEY MD PA
Entity Type:Organization
Organization Name:KRISTINA P HURSEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:P
Authorized Official - Last Name:HURSEY
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:214-618-9715
Mailing Address - Street 1:3550 PARKWOOD BLVD
Mailing Address - Street 2:SUITE
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1903
Mailing Address - Country:US
Mailing Address - Phone:214-618-9715
Mailing Address - Fax:214-618-9716
Practice Address - Street 1:3550 PARKWOOD BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1903
Practice Address - Country:US
Practice Address - Phone:214-618-9715
Practice Address - Fax:214-618-9716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DF6575OtherRAILROAD MEDICARE PTAN
TX00178ZMedicare PIN