MEDICARE: MURRAY F. NANCE PA-C

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	363AM0700X	Medical Physician Assistant	11027	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

General Provider Information

NPI Number	:	1609877299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MURRAY F. NANCE PA-C

Provider Business Mailing Address
First Line	:	155 E. SONTERRA BLVD
Second Line	:	SUITE 101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3987
Country	:	US
Telephone Number	:	210-474-0530
Fax Number	:	210-474-0532

Provider Business Practice Location Address
First Line	:	1920 E RIVERSIDE DR STE A-110
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-1348
Country	:	US
Telephone Number	:	123-261-6005
Fax Number	:	123-261-6065

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/15/2020

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