Provider Demographics
NPI:1487815718
Name:IMUR FAMILY MEDICAL
Entity Type:Organization
Organization Name:IMUR FAMILY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:O
Authorized Official - Last Name:MURCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:469-767-7828
Mailing Address - Street 1:7310 S. WESTMORELAND
Mailing Address - Street 2:SUITE 9
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237
Mailing Address - Country:US
Mailing Address - Phone:972-780-1122
Mailing Address - Fax:972-780-1295
Practice Address - Street 1:7310 S WESTMORELAND RD
Practice Address - Street 2:SUITE 9
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2998
Practice Address - Country:US
Practice Address - Phone:972-780-1122
Practice Address - Fax:972-780-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121173202Medicaid
TX121173202Medicaid