Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD2021-0007 | NM |
N | 208800000X | Urologist | S9311 | TX |
NPI | 1033573274 |
---|---|
Provider Name | Jesus Herrera-Murillo |
First Address | Las Cruces, NM 88011-9107 |
Second Address | San Antonio, TX 78229-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2016 |
Last Update Date | 26/05/2021 |