Provider Demographics
NPI:1104662006
Name:MURRAY, WIVINE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:WIVINE
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 SAN MARINO DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-4556
Mailing Address - Country:US
Mailing Address - Phone:469-328-8887
Mailing Address - Fax:
Practice Address - Street 1:150 BAILEY RANCH RD
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-3221
Practice Address - Country:US
Practice Address - Phone:682-703-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist