Provider Demographics
NPI:1477828077
Name:CARLOS MURILLO MD PA
Entity Type:Organization
Organization Name:CARLOS MURILLO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:MURILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-799-3322
Mailing Address - Street 1:7400 FANNIN ST STE 1160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1949
Mailing Address - Country:US
Mailing Address - Phone:832-582-8114
Mailing Address - Fax:832-830-8927
Practice Address - Street 1:7400 FANNIN ST STE 1160
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1949
Practice Address - Country:US
Practice Address - Phone:832-582-8114
Practice Address - Fax:832-830-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6787208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB159653Medicare PIN