Healthcare Provider Details

I. General information

NPI: 1639353402
Provider Name (Legal Business Name): HOLLY COUTURE MURRAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 COORS BLVD NW SUITE 200
ALBUQUERQUE NM
87120-1173
US

IV. Provider business mailing address

PO BOX 26028
ALBUQUERQUE NM
87125-6028
US

V. Phone/Fax

Practice location:
  • Phone: 505-839-2300
  • Fax: 505-839-2303
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA-1435-08
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: