MEDICARE: DR. JOHN P MURPHY DDS

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	122300000X	Dentist	TX12604	TX

General Provider Information

NPI Number	:	1336386044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN P MURPHY DDS

Provider Business Mailing Address
First Line	:	1609 EVERMAN PKWY
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76140
Country	:	US
Telephone Number	:	817-551-1288
Fax Number	:	817-551-9292

Provider Business Practice Location Address
First Line	:	1609 EVERMAN PKWY
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76140
Country	:	US
Telephone Number	:	817-551-1288
Fax Number	:	817-551-9292

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

Provider Enumeration Date	:	01/16/2009
Last Update Date	:	01/16/2009

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