Provider Demographics
NPI:1063575082
Name:MURRAY, TESHANA NATE (DDS)
Entity type:Individual
Prefix:
First Name:TESHANA
Middle Name:NATE
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 AERIAL BROOK TRL
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-8755
Mailing Address - Country:US
Mailing Address - Phone:512-929-7888
Mailing Address - Fax:512-929-8454
Practice Address - Street 1:1144 AIRPORT BLVD STE 240
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3165
Practice Address - Country:US
Practice Address - Phone:512-929-7888
Practice Address - Fax:512-929-8091
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice