Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 224P00000X | TX |
NPI | 1417411166 |
---|---|
Provider Name | Sophia Murphy |
First Address | Glenn Heights, TX 75154-8270 |
Second Address | Glenn Heights, TX 75154-8270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2019 |
Last Update Date | 28/01/2019 |