Basic Information
| Provider Information | |||||||||
| NPI: | 1538401583 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MURDOCK | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3375 SW TERWILLIGER BLVD | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972394146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034943000 | ||||||||
| FaxNumber: | 5034944286 | ||||||||
| Practice Location | |||||||||
| Address1: | 3730 KIRBY DR STE 900 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770983976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137950705 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2013 | ||||||||
| LastUpdateDate: | 06/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | BP10048608 | TX | N | Allopathic & Osteopathic Physicians | Ophthalmology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207W00000X | MD181809 | OR | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0200X | S3027 | TX | Y |
No ID Information.