Provider Demographics
NPI:1184043812
Name:MURPHY, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 ANDREWS HWY
Mailing Address - Street 2:APT 907
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-6332
Mailing Address - Country:US
Mailing Address - Phone:714-357-9926
Mailing Address - Fax:
Practice Address - Street 1:607 W AVENUE B
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-1553
Practice Address - Country:US
Practice Address - Phone:254-547-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist