Provider Demographics
NPI:1235465287
Name:MUNOZ, AMARISA AMELIA (DC)
Entity Type:Individual
Prefix:DR
First Name:AMARISA
Middle Name:AMELIA
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMARISA
Other - Middle Name:AMELIA
Other - Last Name:GAMBOA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6507 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-3763
Mailing Address - Country:US
Mailing Address - Phone:214-801-9646
Mailing Address - Fax:806-771-9333
Practice Address - Street 1:8207 HUDSON AVE STE D
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2805
Practice Address - Country:US
Practice Address - Phone:806-548-7247
Practice Address - Fax:806-771-9333
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor