Provider Demographics
NPI:1912030248
Name:HURLEY, JANET (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:HURLEY
Suffix:
Gender:F
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:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6450
Mailing Address - Fax:
Practice Address - Street 1:601 N HIGHWAY 110
Practice Address - Street 2:BAY O
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791
Practice Address - Country:US
Practice Address - Phone:903-839-2585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2945207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149849505Medicaid
TX75-2616977-129OtherTRICARE
TX8D8557Medicare Oscar/Certification
TXP00374251Medicare PIN
TX149849505Medicaid
TX75-2616977-129OtherTRICARE