Healthcare Provider Details

I. General information

NPI: 1629623624
Provider Name (Legal Business Name): MARIAM MUNEER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 N GREENVILLE AVE SUITE 113 #370
ALLEN TX
75002
US

IV. Provider business mailing address

1108 N GREENVILLE AVE SUITE 113 #370
ALLEN TX
75002
US

V. Phone/Fax

Practice location:
  • Phone: 205-566-4495
  • Fax:
Mailing address:
  • Phone: 205-566-4495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.44762
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberV2176
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: