MEDICARE: JORGE MUNOZ, M.D., P.A.

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	174400000X	Specialist	J7596	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100355001	OTHER	TX	TPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4108866	OTHER	TX	BLUE LINK

General Provider Information

NPI Number	:	1578700027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JORGE MUNOZ, M.D., P.A.

Provider Business Mailing Address
First Line	:	2515 BABCOCK RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4807
Country	:	US
Telephone Number	:	210-614-3004
Fax Number	:	210-593-0081

Provider Business Practice Location Address
First Line	:	2515 BABCOCK RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4807
Country	:	US
Telephone Number	:	210-614-3004
Fax Number	:	210-593-0081

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JORGE MUNOZ
Credential	:	M.D.
Telephone Number	:	210-614-3004

Provider Enumeration Date	:	01/20/2009
Last Update Date	:	01/20/2009

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Directions to “JORGE MUNOZ, M.D., P.A. ” Practice Location

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