Provider Demographics
NPI:1194898395
Name:MUNOZ, WILFREDO ALFONSO (MD)
Entity type:Individual
Prefix:
First Name:WILFREDO
Middle Name:ALFONSO
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2928
Mailing Address - Country:US
Mailing Address - Phone:956-627-2483
Mailing Address - Fax:956-627-2677
Practice Address - Street 1:700 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2928
Practice Address - Country:US
Practice Address - Phone:956-627-2483
Practice Address - Fax:956-627-2677
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4890207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189405703Medicaid
TX8CR201OtherBCBS
TXP01114744OtherRR MEDICARE
TXTXB123737OtherMEDICARE
TXM4890OtherMEDICAL LICENSE