Provider Demographics
NPI:1407465487
Name:MUNSCH, TABITHA DAWN
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:DAWN
Last Name:MUNSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-8967
Mailing Address - Country:US
Mailing Address - Phone:936-500-0846
Mailing Address - Fax:
Practice Address - Street 1:231 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8967
Practice Address - Country:US
Practice Address - Phone:936-500-0846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)