Organization
PAIN CLINIC PA RICHARD K. HURLEY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD KENNETH HURLEY M.D. (PRESIDENT)
(254) 235-4414
Entity
Organization
Contact information
Practice address
405 LONDONDERRY DR, SUITE #311, WACO, TX 76712-7922
(254) 235-4414
(254) 235-7378
Mailing address
405 LONDONDERRY, SUITE #311, WACO, TX 76712-7922
(254) 235-4414
(254) 235-7378
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
E8581
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076ER
BLUE CROSS GROUP
TX
05
—
1206112-03
—
TX
01
—
CE0492
RAILROAD MEDICARE
TX
Enumeration date
08/04/2006
Last updated
12/05/2011
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