Provider Demographics
NPI:1376838896
Name:MURPHY, EDWINA (OTR/ATP)
Entity Type:Individual
Prefix:
First Name:EDWINA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OTR/ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 FM 1960 RD E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5229
Mailing Address - Country:US
Mailing Address - Phone:832-445-0956
Mailing Address - Fax:832-777-7023
Practice Address - Street 1:2111 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5229
Practice Address - Country:US
Practice Address - Phone:832-445-0956
Practice Address - Fax:832-777-7023
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108345225X00000X
TX3394247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108345OtherOTR
TX3394OtherATP