Provider Demographics
NPI:1194907956
Name:MARIA MUNOZ MD PA
Entity type:Organization
Organization Name:MARIA MUNOZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DE JESUS
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-361-3050
Mailing Address - Street 1:PO BOX 1046
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-0011
Mailing Address - Country:US
Mailing Address - Phone:956-361-3050
Mailing Address - Fax:956-361-3055
Practice Address - Street 1:2395 LA PALMA ST STE H-I
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-3320
Practice Address - Country:US
Practice Address - Phone:956-361-3050
Practice Address - Fax:956-361-3055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y883OtherMEDICARE
TX195883701Medicaid
TX195883701Medicaid