Provider Demographics
NPI:1982924544
Name:MUNOZ, AERIDES (PT)
Entity type:Individual
Prefix:
First Name:AERIDES
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 SOUTH DIPLOMAT DRIVE
Mailing Address - Street 2:APT 2
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577
Mailing Address - Country:US
Mailing Address - Phone:956-584-8100
Mailing Address - Fax:956-584-8149
Practice Address - Street 1:844 E EXPRESSWAY 83
Practice Address - Street 2:KIDIATRICS THERAPY SERVICES
Practice Address - City:LA JOYA
Practice Address - State:TX
Practice Address - Zip Code:78560
Practice Address - Country:US
Practice Address - Phone:956-584-8100
Practice Address - Fax:956-584-8149
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1195338225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist