Healthcare Provider Details

I. General information

NPI: 1417536590
Provider Name (Legal Business Name): JUSTIN MARQUEZ MURPHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ROSALIND REDFERN GROVER PKWY STE 120
MIDLAND TX
79701-5849
US

IV. Provider business mailing address

400 ROSALIND REDFERN GROVER PKWY STE 120
MIDLAND TX
79701-5849
US

V. Phone/Fax

Practice location:
  • Phone: 432-221-1111
  • Fax:
Mailing address:
  • Phone: 432-221-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberW5144
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDR.0075104
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberW5144
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: