Provider Demographics
NPI:1427653237
Name:MURRELL, TODD ANDERSON (LAT)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:ANDERSON
Last Name:MURRELL
Suffix:
Gender:M
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 GINGER BAY PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1010
Mailing Address - Country:US
Mailing Address - Phone:346-382-0703
Mailing Address - Fax:
Practice Address - Street 1:27330 OAK RIDGE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-9042
Practice Address - Country:US
Practice Address - Phone:832-592-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT83202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer