Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | Q5047 | TX |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | Q5047 | TX |
NPI | 1225338932 |
---|---|
Provider Name | Pavel I Muradov |
First Address | Houston, TX 77002-2714 |
Second Address | Katy, TX 77450-3419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2010 |
Last Update Date | 17/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
370484301 | (05) | TX |