Provider Demographics
NPI:1649423427
Name:MUNIZ, VERONICA (MS, RD, LD, IBCLC)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:MS, RD, LD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16875 OLYMPIC NATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4261
Mailing Address - Country:US
Mailing Address - Phone:281-414-7564
Mailing Address - Fax:
Practice Address - Street 1:16875 OLYMPIC NATIONAL DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4261
Practice Address - Country:US
Practice Address - Phone:281-414-7564
Practice Address - Fax:844-444-1104
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-309148174N00000X
TXDT80451133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN