Basic Information
Provider Information
NPI: 1871563437
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLCOMB
FirstName: MURRAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4616 W HOWARD LN
Address2:  
City: AUSTIN
State: TX
PostalCode: 787286300
CountryCode: US
TelephoneNumber: 5123248960
FaxNumber:  
Practice Location
Address1: 601 E 15TH ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787011930
CountryCode: US
TelephoneNumber: 5123248960
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/25/2006
LastUpdateDate: 03/16/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X04-22200KSN Allopathic & Osteopathic PhysiciansSurgery 
208600000XQ2560TXY Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
35968840205TX MEDICAID
100127560 A05KS MEDICAID
35968840105TX MEDICAID


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