MEDICARE: DR. DANIEL MUNOZ-SANTAMARIA PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	37179	TX
2	103T00000X	Psychologist	37179	TX
3	103TF0200X	Forensic Psychologist	37179	TX
4	103G00000X	Clinical Neuropsychologist	37179	TX

General Provider Information

NPI Number	:	1437605797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL MUNOZ-SANTAMARIA PHD

Provider Business Mailing Address
First Line	:	14 LUCAS LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76134-3407
Country	:	US
Telephone Number	:	817-807-6016
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 LUCAS LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76134-3407
Country	:	US
Telephone Number	:	817-807-6016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2016
Last Update Date	:	06/19/2026

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