MEDICARE: AMANDA MURPHY

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	156FX1800X	Optician

General Provider Information

NPI Number	:	1043153554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MURPHY

Provider Business Mailing Address
First Line	:	1311 S JACKSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-3050
Country	:	US
Telephone Number	:	903-589-3714
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 S JACKSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-3050
Country	:	US
Telephone Number	:	903-589-3714
Fax Number	:	903-541-2165

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ AMANDA MURPHY ” Practice Location

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