Provider Demographics
NPI:1598255911
Name:MUNOZ, VANESSA ANN
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:ANN
Last Name:MUNOZ
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 1:8910 OLMSTEAD PARK
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3745
Mailing Address - Country:US
Mailing Address - Phone:210-383-2616
Mailing Address - Fax:
Practice Address - Street 1:8910 OLMSTEAD PARK
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-3745
Practice Address - Country:US
Practice Address - Phone:210-383-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion