Provider Demographics
NPI:1457683120
Name:MUNOZ, JOSE LUIS JR (CST/CFA)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LUIS
Last Name:MUNOZ
Suffix:JR
Gender:M
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1631
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-0016
Mailing Address - Country:US
Mailing Address - Phone:956-778-6927
Mailing Address - Fax:
Practice Address - Street 1:416 E 18TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-8032
Practice Address - Country:US
Practice Address - Phone:956-778-6927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00376246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant