Provider Demographics
NPI:1265094288
Name:MASH, JAMES MURPHY
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MURPHY
Last Name:MASH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SUGAR CRK
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2102
Mailing Address - Country:US
Mailing Address - Phone:512-965-0778
Mailing Address - Fax:
Practice Address - Street 1:152 SUGAR CRK
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-2102
Practice Address - Country:US
Practice Address - Phone:512-965-0778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-29
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38871809172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty