Provider Demographics
NPI:1609465087
Name:MUNOZ, JOEL (STUDENT PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:STUDENT PHARMACIST
Other - Prefix:MR
Other - First Name:JOEL
Other - Middle Name:
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:STUDENT PHARMACIST
Mailing Address - Street 1:7405 ASPEN BROOK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-1758
Mailing Address - Country:US
Mailing Address - Phone:830-421-0828
Mailing Address - Fax:
Practice Address - Street 1:1000 E 41ST ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-4810
Practice Address - Country:US
Practice Address - Phone:512-459-8308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX280611183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician