Provider Demographics
NPI:1154786861
Name:MUNIZ, SASHUA (OTR)
Entity type:Individual
Prefix:MR
First Name:SASHUA
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 PHOENIX ST APT 4
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-4192
Mailing Address - Country:US
Mailing Address - Phone:956-263-5849
Mailing Address - Fax:
Practice Address - Street 1:1706 PHOENIX ST APT 4
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-4192
Practice Address - Country:US
Practice Address - Phone:956-263-5849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116891225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist