Provider Demographics
NPI:1467033779
Name:HUNT, GEORGE CLIFFORD JR
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:CLIFFORD
Last Name:HUNT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3919 FORBESBURY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3941
Mailing Address - Country:US
Mailing Address - Phone:317-716-1123
Mailing Address - Fax:
Practice Address - Street 1:3919 FORBESBURY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3941
Practice Address - Country:US
Practice Address - Phone:317-716-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN67000885A183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician