Healthcare Provider Details

I. General information

NPI: 1669582896
Provider Name (Legal Business Name): JAIME D MURCIA MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 EDGEMERE DR
PLAINVIEW TX
79072
US

IV. Provider business mailing address

PO BOX 800
PLAINVIEW TX
79073
US

V. Phone/Fax

Practice location:
  • Phone: 806-293-1555
  • Fax: 806-296-5657
Mailing address:
  • Phone: 806-293-1555
  • Fax: 806-296-5657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ4661
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberJ4661
License Number StateTX

VIII. Authorized Official

Name: DR. JAIME DANIEL MURCIA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 806-293-1555