Healthcare Provider Details

I. General information

NPI: 1144922188
Provider Name (Legal Business Name): CAROLINE W MURIUKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 S 12TH ST
FORT SMITH AR
72901-4702
US

IV. Provider business mailing address

2052 JUNIPER PASS WAY
MESQUITE TX
75149-3130
US

V. Phone/Fax

Practice location:
  • Phone: 479-785-2431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberW8056
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: