Provider Demographics
NPI:1255130423
Name:MURPHY MD FUNCTIONAL MEDICINE PLLC
Entity type:Organization
Organization Name:MURPHY MD FUNCTIONAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-269-8400
Mailing Address - Street 1:14800 SAN PEDRO AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3733
Mailing Address - Country:US
Mailing Address - Phone:210-253-3313
Mailing Address - Fax:
Practice Address - Street 1:14800 SAN PEDRO AVE STE 204
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3733
Practice Address - Country:US
Practice Address - Phone:210-253-3313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty