Provider Demographics
NPI:1396004115
Name:MUNOZ RIVERA, VANESSA MARIE (MD)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:MUNOZ RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:MARIE
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1301 BARBARA JORDAN BLVD STE 200E
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3078
Mailing Address - Country:US
Mailing Address - Phone:512-628-1880
Mailing Address - Fax:512-628-1881
Practice Address - Street 1:1301 BARBARA JORDAN BLVD STE 200E
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3078
Practice Address - Country:US
Practice Address - Phone:512-628-1880
Practice Address - Fax:512-628-1881
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS16662080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology