Provider Demographics
NPI:1043261688
Name:MUNTON, DANIEL L (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:MUNTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 RIDGEMONT DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-8746
Mailing Address - Country:US
Mailing Address - Phone:325-698-4545
Mailing Address - Fax:325-698-4547
Practice Address - Street 1:4351 RIDGEMONT DR
Practice Address - Street 2:SUITE A
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-8746
Practice Address - Country:US
Practice Address - Phone:325-698-4545
Practice Address - Fax:325-698-4547
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1266208100000X, 2081P2900X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120045101OtherFIRSCARE
TX1723395OtherFIRST HEALTH
TX8V4080OtherBCBS
TX4200747OtherBLUE LINK
TXP00324069OtherMEDICARE RAILROAD
TX8F3225Medicare PIN
TX4200747OtherBLUE LINK