Provider Demographics
NPI:1407426844
Name:MUNOZ, TYLER REY (DDS)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:REY
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 RED DUSK PAINT DR
Mailing Address - Street 2:
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-1279
Mailing Address - Country:US
Mailing Address - Phone:409-728-6589
Mailing Address - Fax:
Practice Address - Street 1:11 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4123
Practice Address - Country:US
Practice Address - Phone:281-332-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX373541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice