Provider Demographics
NPI:1730137340
Name:MURRAY, CONRAD ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:CONRAD
Middle Name:ROBERT
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72216
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89170-2216
Mailing Address - Country:US
Mailing Address - Phone:702-866-6802
Mailing Address - Fax:702-866-6904
Practice Address - Street 1:2110 E FLAMINGO RD
Practice Address - Street 2:SUITE #301
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5190
Practice Address - Country:US
Practice Address - Phone:702-866-6802
Practice Address - Fax:702-866-6904
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9141207RC0000X
TXM0502207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV060063624OtherMEDICARE RAILROAD
TX1824286Medicaid
TX1824302Medicaid
NV2018221Medicaid
TX8W2140OtherBCBS OF TEXAS
NV1730137340OtherNPI INDIVIDUAL
TX8W2140OtherBCBS OF TEXAS
TX1824302Medicaid
NVV103785Medicare PIN
TX1824286Medicaid