Healthcare Provider Details

I. General information

NPI: 1417681289
Provider Name (Legal Business Name): EPIC MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 W FM 544 STE 1B
MURPHY TX
75094-4587
US

IV. Provider business mailing address

619 W FM 544 STE 1B
MURPHY TX
75094-4587
US

V. Phone/Fax

Practice location:
  • Phone: 469-530-4932
  • Fax:
Mailing address:
  • Phone: 469-530-4932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KHALED HAMADA
Title or Position: OWNER
Credential:
Phone: 469-530-4932