Provider Demographics
NPI:1215974076
Name:JAMES M HURLEY MD PA
Entity type:Organization
Organization Name:JAMES M HURLEY MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-838-5500
Mailing Address - Street 1:2604 SAINT MICHAEL DR
Mailing Address - Street 2:STE 345
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2379
Mailing Address - Country:US
Mailing Address - Phone:903-838-5500
Mailing Address - Fax:903-838-7402
Practice Address - Street 1:2604 SAINT MICHAEL DR
Practice Address - Street 2:STE 345
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2379
Practice Address - Country:US
Practice Address - Phone:903-838-5500
Practice Address - Fax:903-838-7402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR124890002Medicaid
TX00L09SOtherBCBS OF TEXAS
OK100750070AMedicaid
TX083630601Medicaid
AR9R001OtherBCBS OF ARKANSAS
CP9034OtherRAILROAD
TX00L09SOtherBCBS OF TEXAS