Provider Demographics
NPI:1952850430
Name:MURPHY, MADISON (PA-C)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9110
Mailing Address - Country:US
Mailing Address - Phone:214-648-4765
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD.
Practice Address - Street 2:DEPARTMENT OF UROLOGY- UTSW
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9164
Practice Address - Country:US
Practice Address - Phone:210-450-9600
Practice Address - Fax:210-450-6036
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10812363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX366918602OtherCSHCN
TX366918601Medicaid
TX366918601Medicaid