Provider Demographics
NPI:1477550697
Name:AMIN, MURLIDHAR ANATKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:MURLIDHAR
Middle Name:ANATKUMAR
Last Name:AMIN
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 1:2300 HIGHWAY 365 STE 150
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6293
Mailing Address - Country:US
Mailing Address - Phone:409-729-0885
Mailing Address - Fax:409-729-2696
Practice Address - Street 1:2300 HIGHWAY 365 STE 150
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6293
Practice Address - Country:US
Practice Address - Phone:409-729-0885
Practice Address - Fax:409-729-2696
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7888207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1683060OtherMEDICAID
TX1206179-05Medicaid
LA1683060OtherMEDICAID
TX8B3208Medicare ID - Type Unspecified