Provider Demographics
NPI:1104415546
Name:MURRAY, BRIAN JASON (CPHT-ADV)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:JASON
Last Name:MURRAY
Suffix:
Gender:M
Credentials:CPHT-ADV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 IRON EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-6003
Mailing Address - Country:US
Mailing Address - Phone:325-829-9090
Mailing Address - Fax:
Practice Address - Street 1:1345 BARROW ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-5171
Practice Address - Country:US
Practice Address - Phone:325-690-5011
Practice Address - Fax:325-690-5011
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100920183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician