Provider Demographics
NPI:1124495189
Name:MUNAWAR, MONIZA
Entity type:Individual
Prefix:
First Name:MONIZA
Middle Name:
Last Name:MUNAWAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 CARSON DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1715
Mailing Address - Country:US
Mailing Address - Phone:214-948-3364
Mailing Address - Fax:214-948-1339
Practice Address - Street 1:4441 BASS PRO DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-4837
Practice Address - Country:US
Practice Address - Phone:972-349-6320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313521223G0001X, 122300000X, 125K00000X, 125Q00000X, 207P00000X, 207Q00000X, 207ZF0201X, 207ZP0102X, 2085R0202X, 2085R0205X, 208D00000X, 208U00000X, 208VP0014X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No125K00000XDental ProvidersAdvanced Practice Dental Therapist
No125Q00000XDental ProvidersDentistOral Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological Physics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine