Provider Demographics
NPI:1710076120
Name:MUNIZ, SERGIO EDGARDO (MD)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:EDGARDO
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MEDICAL DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4129
Mailing Address - Country:US
Mailing Address - Phone:806-355-9007
Mailing Address - Fax:806-355-5147
Practice Address - Street 1:26 MEDICAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4129
Practice Address - Country:US
Practice Address - Phone:806-355-9007
Practice Address - Fax:806-355-5147
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1325207R00000X, 207RH0002X, 208M00000X, 207RP1001X
NMMD2022-0083207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133996206Medicaid
TX110057863OtherRAILROAD MEDICARE
TX110057863OtherRAILROAD MEDICARE
00H29XMedicare PIN