Provider Demographics
NPI:1356381115
Name:MURRAY M VANN MD PA
Entity type:Organization
Organization Name:MURRAY M VANN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:VANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-598-1005
Mailing Address - Street 1:5959 GATEWAY WEST
Mailing Address - Street 2:STE 120
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3315
Mailing Address - Country:US
Mailing Address - Phone:915-779-1716
Mailing Address - Fax:915-771-6558
Practice Address - Street 1:10400 VISTA DEL SOL DR
Practice Address - Street 2:STE 204
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7924
Practice Address - Country:US
Practice Address - Phone:915-598-1005
Practice Address - Fax:915-590-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDG4567Medicare PIN
TX00003ZMedicare PIN