Provider Demographics
NPI:1194556928
Name:CARLOS E. MUNOZ JR., M.D., P.A.
Entity type:Organization
Organization Name:CARLOS E. MUNOZ JR., M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:E
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:281-342-9503
Mailing Address - Street 1:1601 MAIN STREET
Mailing Address - Street 2:STE 108
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469
Mailing Address - Country:US
Mailing Address - Phone:281-342-9503
Mailing Address - Fax:281-341-5461
Practice Address - Street 1:1601 MAIN STREET
Practice Address - Street 2:STE 108
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469
Practice Address - Country:US
Practice Address - Phone:281-342-9503
Practice Address - Fax:281-341-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101936601Medicaid
TX45D1056254OtherCLIA
TXK2081OtherPHYSICIAN STATE LICENSE