Healthcare Provider Details

I. General information

NPI: 1063602209
Provider Name (Legal Business Name): SMITHA MURTHY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 MILLS AVE AMEP-SETON SHOAL CREEK HOSPITAL
AUSTIN TX
78731-6309
US

IV. Provider business mailing address

1601 RIO GRANDE ST SUITE 340
AUSTIN TX
78701-1137
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-2080
  • Fax:
Mailing address:
  • Phone: 512-324-8960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberN4604
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberN4604
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: