Provider Demographics
NPI:1669556486
Name:HUR, IL (DDS)
Entity type:Individual
Prefix:DR
First Name:IL
Middle Name:
Last Name:HUR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 IRVINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009
Mailing Address - Country:US
Mailing Address - Phone:713-697-2929
Mailing Address - Fax:713-697-0304
Practice Address - Street 1:5801 IRVINGTON BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009
Practice Address - Country:US
Practice Address - Phone:713-697-2929
Practice Address - Fax:713-697-0304
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16845122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB1684501OtherCHIP