Provider Demographics
NPI:1083823637
Name:MUNOZ, JAVIER LUIS (MD, MS, FACP)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:LUIS
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MD, MS, FACP
Other - Prefix:DR
Other - First Name:JORGE
Other - Middle Name:LUIS JAVIER
Other - Last Name:MUNOZ VEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13400 E SHEA BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-5452
Mailing Address - Country:US
Mailing Address - Phone:480-301-8000
Mailing Address - Fax:
Practice Address - Street 1:5881 E MAYO BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-4504
Practice Address - Country:US
Practice Address - Phone:480-342-4800
Practice Address - Fax:480-301-4675
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46881207R00000X, 207RH0003X
MI4301085405207R00000X
TXP1369207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX293565201 (MDACC)Medicaid
TXTXB148178 (MDACC)Medicare PIN