Provider Demographics
NPI:1356659585
Name:MUNOZ, MARCO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:300 E JOHN CARPENTER FWY
Mailing Address - Street 2:SUITE 850
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-2727
Mailing Address - Country:US
Mailing Address - Phone:972-957-3000
Mailing Address - Fax:972-957-3005
Practice Address - Street 1:229 NE 28TH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76164-7205
Practice Address - Country:US
Practice Address - Phone:817-566-0478
Practice Address - Fax:817-566-0484
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN7564207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine