Provider Demographics
NPI:1922446202
Name:MUNIZ, MEGGAN L (LOTA, LVN)
Entity Type:Individual
Prefix:
First Name:MEGGAN
Middle Name:L
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:LOTA, LVN
Other - Prefix:
Other - First Name:MEGGAN
Other - Middle Name:L
Other - Last Name:TREVINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LOTA,LVN
Mailing Address - Street 1:6111 WINDY FRST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-3205
Mailing Address - Country:US
Mailing Address - Phone:210-612-1673
Mailing Address - Fax:
Practice Address - Street 1:7710 W IH 10
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4711
Practice Address - Country:US
Practice Address - Phone:210-377-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210859224Z00000X
TX1012248164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant