Provider Demographics
NPI:1942348438
Name:HOSEA, HURB A (DPM)
Entity Type:Individual
Prefix:
First Name:HURB
Middle Name:A
Last Name:HOSEA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 E 29TH
Mailing Address - Street 2:SUITE 119
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802
Mailing Address - Country:US
Mailing Address - Phone:979-731-8310
Mailing Address - Fax:979-731-8706
Practice Address - Street 1:2801 E 29TH
Practice Address - Street 2:SUITE 119
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802
Practice Address - Country:US
Practice Address - Phone:979-731-8310
Practice Address - Fax:979-731-8706
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1159213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX23011OtherSCOTT & WHITE
TXF000682C4Medicaid
TXF000682C4Medicaid
U17917Medicare UPIN