Provider Demographics
NPI:1043218290
Name:MURILLO, TOMAS (MD)
Entity Type:Individual
Prefix:
First Name:TOMAS
Middle Name:
Last Name:MURILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3899
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79923-3899
Mailing Address - Country:US
Mailing Address - Phone:915-577-0030
Mailing Address - Fax:915-533-2568
Practice Address - Street 1:2415 E YANDELL DR
Practice Address - Street 2:SUITE B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3616
Practice Address - Country:US
Practice Address - Phone:915-577-0030
Practice Address - Fax:915-533-2568
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2023-03-07
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-06-01
Provider Licenses
StateLicense IDTaxonomies
TX207L00000X207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE5416OtherSTATE LICENSE
TX60038723OtherDPS NUMBER
AM8948498OtherDEA NUMBER
TX60038723OtherDPS NUMBER
TXE5416OtherSTATE LICENSE