MEDICARE: EDWINA MURPHY OTR/ATP

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	225X00000X	Occupational Therapist	108345	TX
2	247200000X	Other Technician	3394	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	108345	OTHER	TX	OTR
2	3394	OTHER	TX	ATP

General Provider Information

NPI Number	:	1376838896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWINA MURPHY OTR/ATP

Provider Business Mailing Address
First Line	:	2111 FM 1960 RD E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-5229
Country	:	US
Telephone Number	:	832-445-0956
Fax Number	:	832-777-7023

Provider Business Practice Location Address
First Line	:	2111 FM 1960 RD E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-5229
Country	:	US
Telephone Number	:	832-445-0956
Fax Number	:	832-777-7023

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

Provider Enumeration Date	:	06/13/2011
Last Update Date	:	01/23/2017

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