Provider Demographics
NPI:1124242201
Name:MURRAY, MICHAEL EDMOND (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EDMOND
Last Name:MURRAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 WOODFIN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-6422
Mailing Address - Country:US
Mailing Address - Phone:214-357-6196
Mailing Address - Fax:
Practice Address - Street 1:12860 HILLCREST RD
Practice Address - Street 2:SUITE 203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1530
Practice Address - Country:US
Practice Address - Phone:972-387-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21145103T00000X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent