Provider Demographics
NPI:1013917228
Name:MUNOZ, MARIA DE JESUS (MD)
Entity Type:Individual
Prefix:
First Name:MARIA DE JESUS
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA DE JESUS
Other - Middle Name:
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2102 TREASURE HILLS BLVD # 3.14405
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8736
Mailing Address - Country:US
Mailing Address - Phone:956-296-1437
Mailing Address - Fax:956-296-1326
Practice Address - Street 1:1000 E DOVE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3974
Practice Address - Country:US
Practice Address - Phone:956-362-3520
Practice Address - Fax:956-362-3529
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine