Provider Demographics
NPI:1558713800
Name:MUNIR F BISHARA, M.D.
Entity Type:Organization
Organization Name:MUNIR F BISHARA, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MUNIR
Authorized Official - Middle Name:FARIZ
Authorized Official - Last Name:BISHARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-515-8802
Mailing Address - Street 1:616 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:OVILLA
Mailing Address - State:TX
Mailing Address - Zip Code:75154-5577
Mailing Address - Country:US
Mailing Address - Phone:972-515-8802
Mailing Address - Fax:
Practice Address - Street 1:616 CLINTON ST
Practice Address - Street 2:
Practice Address - City:OVILLA
Practice Address - State:TX
Practice Address - Zip Code:75154-5577
Practice Address - Country:US
Practice Address - Phone:972-515-8802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8862171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty