Individual
CHERYL LYNN HURD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2400
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L6233
TX
2084P0800X
Psychiatry Physician
Primary
L6233
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170627701
—
TX
05
—
170627703
—
TX
01
—
497527
VALUE OPTIONS PROVIDER ID
TX
01
—
8K2993
BCBS PROVIDER ID
TX
01
—
8X5117
BCBS
TX
01
—
P00093872
RAILROAD MCR PROVIDER ID
TX
01
—
P00784421
RAILROAD MEDICARE
TX
Enumeration date
02/27/2007
Last updated
09/20/2011
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