Provider Demographics
NPI:1922219351
Name:HURD, A.B.
Entity Type:Individual
Prefix:MR
First Name:A.B.
Middle Name:
Last Name:HURD
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:A.B.
Other - Middle Name:
Other - Last Name:HURD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:4420 W. OREM
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045
Mailing Address - Country:US
Mailing Address - Phone:713-433-5656
Mailing Address - Fax:713-433-6653
Practice Address - Street 1:4420 W. OREM
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045
Practice Address - Country:US
Practice Address - Phone:713-433-5656
Practice Address - Fax:713-433-6653
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143197Medicaid