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NPI 1255130423

NPI 1255130423 : MURPHY MD FUNCTIONAL MEDICINE PLLC : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1255130423
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    Entity Type          |    Organization 
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    Legal Business Name  |    MURPHY MD FUNCTIONAL MEDICINE PLLC 
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Dates
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    Enumeration Date     |    03/11/2025
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    Last Update Date     |    03/11/2025
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Provider Practice Location Address
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    Address Line         |    14800 SAN PEDRO AVE STE 204 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78232-3733
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    Country              |    US
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    Telephone            |    210-253-3313
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14800 SAN PEDRO AVE STE 204 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78232-3733
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    Country              |    US
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    Telephone            |    210-253-3313
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     CHARLES  MURPHY 
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    Credential           |    MD
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    Telephone            |    210-269-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    
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    License Number State |    
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