Kim H Murray, DDS
Individual provider Active NPI Dentist · Llano, TX
NPI 1265584544 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1265584544
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 14961 (TX)
- Practice address
- 108 W Ollie St
Llano, TX 78643-2626 - Phone
- (325) 247-4213
- Fax
- (325) 247-4213
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160126001417 | TX | Order and Referring Only - Dentist |
4183927197 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14961 | TX | Yes |
Addresses
Primary practice location
108 W Ollie St
Llano, TX 78643-2626
Mailing address
108 W Ollie St
Llano, TX 78643-2626
Phone (325) 247-4213
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D14961 | Other | TX | BLUE CROSS BLUE SHIELD |
Other providers in Llano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.