Provider Demographics
NPI:1184727398
Name:HURST AMBULATORY SURGICAL CENTER
Entity type:Organization
Organization Name:HURST AMBULATORY SURGICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-455-0220
Mailing Address - Street 1:3900 JOE RAMSEY BLVD E # 10
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7727
Mailing Address - Country:US
Mailing Address - Phone:903-455-0220
Mailing Address - Fax:903-455-2845
Practice Address - Street 1:3900 JOE RAMSEY BLVD E # 10
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7727
Practice Address - Country:US
Practice Address - Phone:903-455-0220
Practice Address - Fax:903-455-2845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007232261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
490004936OtherRAILROAD MEDICARE
TX143333601Medicaid
TX143333601Medicaid