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1225119126

NPI Code Detail

MEDICARE: LESLEY C MURCHISON MD

MEDICARE: LESLEY C MURCHISON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	H0667	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1750369203	OTHER		GRP NPI NUMBER
2	1392580	OTHER	TX	UHC PIN
3	4140237	OTHER	TX	AETNA PIN
4	87043G	OTHER	TX	BCBSTX IND PIN
5	00U87Z	OTHER	TX	BCBSTX GRP PIN
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	120049100	OTHER	TX	FIRSTCARE PIN
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	4340938	OTHER	TX	CIGNA PIN
12	MURLB25033	OTHER	TX	CCHIP PIN
13	46864	OTHER	TX	FIRSTHEALTH PIN

General Provider Information

NPI Number	:	1225119126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLEY C MURCHISON MD

Provider Business Mailing Address
First Line	:	PO BOX 99371
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76199-0371
Country	:	US
Telephone Number	:	682-885-1855
Fax Number	:	682-885-7347

Provider Business Practice Location Address
First Line	:	1300 W LANCASTER AVE
Second Line	:	STE 101
City	:	FORT WORTH
State	:	TX
Zip	:	76102-3410
Country	:	US
Telephone Number	:	817-870-2910
Fax Number	:	817-870-2180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	05/12/2010

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Directions to “ LESLEY C MURCHISON MD” Practice Location

Language	Start Address	Practice Location

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