Provider Demographics
NPI:1710926639
Name:COUSINS MURRELL MEDICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:COUSINS MURRELL MEDICAL SOLUTIONS LLC
Other - Org Name:CMMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILDER
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-933-9614
Mailing Address - Street 1:6140 HIGHWAY 6
Mailing Address - Street 2:SUITE 83
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3802
Mailing Address - Country:US
Mailing Address - Phone:281-933-9614
Mailing Address - Fax:281-495-4068
Practice Address - Street 1:13003 MURPHY RD
Practice Address - Street 2:SUITE M-8
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3956
Practice Address - Country:US
Practice Address - Phone:281-933-9614
Practice Address - Fax:281-495-4068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0086148332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180652302Medicaid
TX531927OtherBLUE CROSS BLUE SHIELD
TX531927OtherBLUE CROSS BLUE SHIELD