Provider Demographics
NPI:1174781934
Name:ALBERT L. HIRSCH, JR., M.D. P.A.
Entity type:Organization
Organization Name:ALBERT L. HIRSCH, JR., M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-421-1188
Mailing Address - Street 1:1902 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215-2807
Mailing Address - Country:US
Mailing Address - Phone:214-421-1188
Mailing Address - Fax:214-421-2410
Practice Address - Street 1:1902 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-2807
Practice Address - Country:US
Practice Address - Phone:214-421-1188
Practice Address - Fax:214-421-2410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4732208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0009GNOtherBCBS