Organization Active NPI

Pain Clinic PA Richard K. Hurley MD

  • Pain Medicine (Anesthesiology) Physician
  • Waco, TX
National Provider Identifier
1871501023
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
E8581 Issued in TX
Legal business name
PAIN CLINIC PA RICHARD K. HURLEY MD
Practice address
405 Londonderry Dr
Suite #311
Waco, TX 76712-7922
Phone
(254) 235-4414
Fax
(254) 235-7378
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Authorized official

Name
Richard Kenneth Hurley, M.D.
Title
President
Phone
(254) 235-4414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X E8581 TX Primary

Addresses

Primary practice location

405 Londonderry Dr
Suite #311
Waco, TX 76712-7922

Mailing address

405 Londonderry
Suite #311
Waco, TX 76712-7922
Phone (254) 235-4414

Other identifiers 3

IdentifierTypeStateIssuer
CE0492OtherTXRAILROAD MEDICARE
0076EROtherTXBLUE CROSS GROUP
1206112-03MedicaidTX

National Provider Directory

National Provider Directory

Locations

2200 N 25th St
Waco, TX 76708
Phone (254) 235-4414

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1871501023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY",
            "address_2": "SUITE #311",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127922",
            "telephone_number": "254-235-4414",
            "fax_number": "254-235-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR",
            "address_2": "SUITE #311",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127922",
            "telephone_number": "254-235-4414",
            "fax_number": "254-235-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CLINIC PA RICHARD K. HURLEY MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-235-4414",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "E8581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE0492",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP",
            "identifier": "0076ER",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1206112-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.