Provider Demographics
NPI:1972674695
Name:CYRUS, MURIEL P (MD)
Entity Type:Individual
Prefix:
First Name:MURIEL
Middle Name:P
Last Name:CYRUS
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 1:100 SE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:KERENS
Mailing Address - State:TX
Mailing Address - Zip Code:75144-3008
Mailing Address - Country:US
Mailing Address - Phone:903-396-7217
Mailing Address - Fax:
Practice Address - Street 1:100 SE 4TH ST
Practice Address - Street 2:
Practice Address - City:KERENS
Practice Address - State:TX
Practice Address - Zip Code:75144-3008
Practice Address - Country:US
Practice Address - Phone:903-396-7217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3010207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T80DOtherBLUE SHIELD
00T80DMedicare PIN
TX00T80DOtherBLUE SHIELD