Healthcare Provider Details

I. General information

NPI: 1043261688
Provider Name (Legal Business Name): DANIEL L MUNTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 08/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 RIDGEMONT DR SUITE A
ABILENE TX
79606-8746
US

IV. Provider business mailing address

4351 RIDGEMONT DR SUITE A
ABILENE TX
79606-8746
US

V. Phone/Fax

Practice location:
  • Phone: 325-698-4545
  • Fax: 325-698-4547
Mailing address:
  • Phone: 325-698-4545
  • Fax: 325-698-4547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberK1266
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberK1266
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberK1266
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: