Provider Demographics
NPI:1346273034
Name:BOREHAM, MURIEL K (MD)
Entity Type:Individual
Prefix:DR
First Name:MURIEL
Middle Name:K
Last Name:BOREHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 SWISS AVENUE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204
Mailing Address - Country:US
Mailing Address - Phone:214-820-8700
Mailing Address - Fax:214-818-8707
Practice Address - Street 1:4501 SWISS AVENUE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:214-820-8700
Practice Address - Fax:214-818-8707
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8017207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138577514Medicaid
TX8P6748OtherBCBS
TX138577513Medicaid
TX138577515Medicaid
TX138577516Medicaid
TX8L27478Medicare PIN
G97674Medicare UPIN
TX8P6748OtherBCBS
TX138577515Medicaid
TXTXB100118Medicare PIN
TX138577514Medicaid
TX138577513Medicaid
TX138577516Medicaid
TX8D6593Medicare PIN