MEDICARE: JYOTI SRIDHAR MURTHY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	L8138	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	L8138	OTHER	TX	LICENSE TX

General Provider Information

NPI Number	:	1013112341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JYOTI SRIDHAR MURTHY MD

Provider Business Mailing Address
First Line	:	3044 OLD DENTON ROAD
Second Line	:	SUITE 138
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5099
Country	:	US
Telephone Number	:	972-245-0007
Fax Number	:	972-245-9272

Provider Business Practice Location Address
First Line	:	3044 OLD DENTON ROAD
Second Line	:	SUITE 138
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5099
Country	:	US
Telephone Number	:	972-245-0007
Fax Number	:	972-245-9272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	05/03/2011

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