1194556928 NPI number — CARLOS E. MUNOZ JR., M.D., P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194556928 NPI number — CARLOS E. MUNOZ JR., M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARLOS E. MUNOZ JR., M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194556928
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 MAIN STREET
Provider Second Line Business Mailing Address:
STE 108
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-342-9503
Provider Business Mailing Address Fax Number:
281-341-5461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 MAIN STREET
Provider Second Line Business Practice Location Address:
STE 108
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-342-9503
Provider Business Practice Location Address Fax Number:
281-341-5461
Provider Enumeration Date:
08/13/2024

Additional Information

Authorized Official

Authorized Official Last Name:
MUNOZ
Authorized Official First Name:
CARLOS
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
281-342-9503

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 101936601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 45D1056254 . This is a "CLIA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: K2081 . This is a "PHYSICIAN STATE LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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