Provider Demographics
NPI:1669582896
Name:JAIME D MURCIA MD
Entity type:Organization
Organization Name:JAIME D MURCIA MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MURCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-293-1555
Mailing Address - Street 1:PO BOX 800
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79073
Mailing Address - Country:US
Mailing Address - Phone:806-293-1555
Mailing Address - Fax:806-296-5657
Practice Address - Street 1:2202 EDGEMERE DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072
Practice Address - Country:US
Practice Address - Phone:806-293-1555
Practice Address - Fax:806-296-5657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4661208000000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX063655701Medicaid
105468100OtherF/C RHC
TX130481805OtherSUPERIOR
TX063655701Medicaid
TX458956Medicare PIN