Provider Demographics
NPI:1447289848
Name:MURRAY, ANNETTE E (PT)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:E
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11882 GREENVILLE AVE
Mailing Address - Street 2:SUITE B127
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-0586
Mailing Address - Country:US
Mailing Address - Phone:469-364-3420
Mailing Address - Fax:469-364-3421
Practice Address - Street 1:11882 GREENVILLE AVE
Practice Address - Street 2:SUITE B127
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-0586
Practice Address - Country:US
Practice Address - Phone:469-364-3420
Practice Address - Fax:469-364-3421
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1191138225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB127136Medicare PIN