Provider Demographics
NPI:1790914620
Name:MUNOZ, MICHELE GENE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:GENE
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:GENE
Other - Last Name:BEAVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4933 W CAUSEWAY BLVD APT 4102
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78402-1412
Mailing Address - Country:US
Mailing Address - Phone:720-600-9785
Mailing Address - Fax:
Practice Address - Street 1:246 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-1916
Practice Address - Country:US
Practice Address - Phone:361-758-6224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM22005111N00000X
WY742111N00000X, 111NX0100X
CO7494111N00000X
TX11217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11217OtherTEXAS BOARD OF CHIROPRACTIC
WY11995440Medicare UPIN