Basic Information
Provider Information
NPI: 1508193517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURRAY
FirstName: ROBERT
MiddleName: KEIH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1109 W BAKER RD STE C
Address2:  
City: BAYTOWN
State: TX
PostalCode: 775212365
CountryCode: US
TelephoneNumber: 2814224292
FaxNumber: 2814275828
Practice Location
Address1: 1109 W BAKER RD STE C
Address2:  
City: BAYTOWN
State: TX
PostalCode: 775212365
CountryCode: US
TelephoneNumber: 2814224292
FaxNumber: 2814275828
Other Information
ProviderEnumerationDate: 11/11/2009
LastUpdateDate: 11/11/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X50248TXY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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