Provider Demographics
NPI:1710987383
Name:COLGIN, MURRAY M (MD)
Entity Type:Individual
Prefix:
First Name:MURRAY
Middle Name:M
Last Name:COLGIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MURRAY
Other - Middle Name:M
Other - Last Name:COLGIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:703 HILL COUNTRY DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6441
Mailing Address - Country:US
Mailing Address - Phone:830-895-7676
Mailing Address - Fax:830-792-9637
Practice Address - Street 1:703 HILL COUNTRY DR
Practice Address - Street 2:SUITE301
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6159
Practice Address - Country:US
Practice Address - Phone:830-895-7676
Practice Address - Fax:830-792-9637
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8811207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131135906Medicaid
TX1311359-07OtherMEDICARE
TX1859175-01OtherMEDICARE GROUP
TX1859175011OtherMEDICAID GROUP
TX1859175011OtherMEDICAID GROUP
B21934Medicare UPIN