Organization Active NPI

Hurst Medical Clinic Corp

  • Geriatric Medicine (Family Medicine) Physician
  • Hurst, TX
National Provider Identifier
1629789524
Registry record updated Apr 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
HURST MEDICAL CLINIC CORP
Practice address
330 Grapevine Hwy
Hurst, TX 76054-2429
Phone
(469) 909-8692
NPI assigned
Dec 12, 2022
Last updated
Apr 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Sady Rodriguez
Title
President
Phone
(469) 909-8692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU Primary

Addresses

Primary practice location

330 Grapevine Hwy
Hurst, TX 76054-2429

Mailing address

2224 Roberts Cutoff Rd
Fort Worth, TX 76114-1889
Phone (469) 909-8692

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714176000000",
    "number": "1629789524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 ROBERTS CUTOFF RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761141889",
            "telephone_number": "469-909-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 GRAPEVINE HWY",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760542429",
            "telephone_number": "469-909-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURST MEDICAL CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2024-04-27",
        "certification_date": "2024-04-27",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "SADY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-909-8692",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.