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NPI Code Detail

MEDICARE: EDWIN V MURR O.D.

MEDICARE: EDWIN V MURR O.D.
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
1152W00000XOptometrist2303TGTX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10258090001OTHERTXMEDICARE DMERC SUPPLIER

General Provider Information

NPI Number : 1326031766
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWIN V MURR O.D.
Provider Business Mailing Address
First Line : 1334 E PIONEER PKWY
Second Line :
City : ARLINGTON
State : TX
Zip : 76010-6411
Country : US
Telephone Number : 817-461-4453
Fax Number : 817-861-2516
Provider Business Practice Location Address
First Line : 1334 E PIONEER PKWY
Second Line :
City : ARLINGTON
State : TX
Zip : 76010-6411
Country : US
Telephone Number : 817-461-4453
Fax Number : 817-861-2516
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 11/29/2007

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