Provider Demographics
NPI:1245082825
Name:ATLAS PEDIATRIC HEALTHCARE, PLLC
Entity type:Organization
Organization Name:ATLAS PEDIATRIC HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:III
Authorized Official - Credentials:PNP
Authorized Official - Phone:210-246-2476
Mailing Address - Street 1:325 N CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:PEARSALL
Mailing Address - State:TX
Mailing Address - Zip Code:78061-2509
Mailing Address - Country:US
Mailing Address - Phone:210-246-2476
Mailing Address - Fax:
Practice Address - Street 1:325 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:PEARSALL
Practice Address - State:TX
Practice Address - Zip Code:78061-2509
Practice Address - Country:US
Practice Address - Phone:210-246-2476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty