Basic Information
| Provider Information | |||||||||
| NPI: | 1760437040 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALAN K MUNOZ MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12200 PARK CENTRAL DR | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752512100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724905970 | ||||||||
| FaxNumber: | 9724905632 | ||||||||
| Practice Location | |||||||||
| Address1: | 12200 PARK CENTRAL DR | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752512100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724905970 | ||||||||
| FaxNumber: | 9724905632 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 06/22/2011 | ||||||||
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| AuthorizedOfficialLastName: | MUNOZ | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9724905970 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2500X | F6292 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
ID Information
| ID | Type | State | Issuer | Description | F6292 | 01 | TX | STATE LICENSE | OTHER |