Provider Demographics
NPI:1831285014
Name:MURR, MARILYN G (MD)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:G
Last Name:MURR
Suffix:
Gender:F
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 66308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-6308
Mailing Address - Country:US
Mailing Address - Phone:832-548-5000
Mailing Address - Fax:
Practice Address - Street 1:3811 LYONS AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-8306
Practice Address - Country:US
Practice Address - Phone:832-548-5000
Practice Address - Fax:832-548-5482
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125130806Medicaid
TX125130809Medicaid
TX125130810Medicaid
TX125130808Medicaid
TX125130809Medicaid
TX125130810Medicaid
TX8A6213Medicare PIN
TX8A6214Medicare PIN