MEDICARE: DR. JAMES DALE MURRAY OD

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	152W00000X	Optometrist	287	NM

General Provider Information

NPI Number	:	1457338170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DALE MURRAY OD

Provider Business Mailing Address
First Line	:	4002 SAINT ANDREWS DR SE
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87124-2143
Country	:	US
Telephone Number	:	505-850-2920
Fax Number	:	505-892-0575

Provider Business Practice Location Address
First Line	:	801 VASSAR DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-2725
Country	:	US
Telephone Number	:	505-248-4003
Fax Number	:	505-248-7721

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	09/20/2011

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