Provider Demographics
NPI:1154761195
Name:MUNOZ, RITO JOEL (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:RITO
Middle Name:JOEL
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2223 NE 28TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76106-7418
Mailing Address - Country:US
Mailing Address - Phone:817-624-3211
Mailing Address - Fax:817-625-9835
Practice Address - Street 1:2223 NE 28TH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76106-7418
Practice Address - Country:US
Practice Address - Phone:817-624-3211
Practice Address - Fax:817-625-9835
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08469363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant