Provider Demographics
NPI:1104987973
Name:MUNIZ, OSCAR JR (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:
Last Name:MUNIZ
Suffix:JR
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WATERWAY AVE
Mailing Address - Street 2:#2109
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3449
Mailing Address - Country:US
Mailing Address - Phone:936-524-6028
Mailing Address - Fax:936-524-6028
Practice Address - Street 1:1 WATERWAY AVE
Practice Address - Street 2:#2109
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3449
Practice Address - Country:US
Practice Address - Phone:936-524-6028
Practice Address - Fax:936-524-6028
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21471223S0112X
TX207801223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0TH000Medicare UPIN