Provider Demographics
NPI:1588840821
Name:GEORGE J MURILLO, M.D., P.A.
Entity Type:Organization
Organization Name:GEORGE J MURILLO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MURILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:281-351-7204
Mailing Address - Street 1:425 HOLDERRIETH BLVD
Mailing Address - Street 2:SUITE # 112
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4543
Mailing Address - Country:US
Mailing Address - Phone:281-351-7204
Mailing Address - Fax:281-351-9059
Practice Address - Street 1:425 HOLDERRIETH BLVD
Practice Address - Street 2:SUITE # 112
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4543
Practice Address - Country:US
Practice Address - Phone:281-351-7204
Practice Address - Fax:281-351-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0564207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N257Medicare PIN