1336880285 NPI number — MURPHY DFW INTERNAL MEDICINE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336880285 NPI number — MURPHY DFW INTERNAL MEDICINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MURPHY DFW INTERNAL MEDICINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336880285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1041 CLIFF CREEK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROSPER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75078-9021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-326-3536
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4944 PRESTON RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034-8597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-326-3536
Provider Business Practice Location Address Fax Number:
469-453-0927
Provider Enumeration Date:
04/05/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MURPHY
Authorized Official First Name:
GRADY
Authorized Official Middle Name:
FRED
Authorized Official Title or Position:
MEDICAL DOCTOR
Authorized Official Telephone Number:
469-215-2511

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)