MEDICARE: DR. JOSE ISAIAS MUNIZ D.C.

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	111N00000X	Chiropractor	9422	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	608115	OTHER	TX	BC/BS OF TEXAS

General Provider Information

NPI Number	:	1770537979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE ISAIAS MUNIZ D.C.

Provider Business Mailing Address
First Line	:	1091 GRAND PASS
Second Line	:
City	:	CANYON LAKE
State	:	TX
Zip	:	78133-3376
Country	:	US
Telephone Number	:	830-800-1105
Fax Number	:	915-503-2087

Provider Business Practice Location Address
First Line	:	1091 GRAND PASS
Second Line	:
City	:	CANYON LAKE
State	:	TX
Zip	:	78133-3376
Country	:	US
Telephone Number	:	838-800-1105
Fax Number	:	915-503-2087

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	11/05/2024

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