Healthcare Provider Details

I. General information

NPI: 1558856468
Provider Name (Legal Business Name): ZAHARA MUNIS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N BELL BLVD # 102
CEDAR PARK TX
78613-7018
US

IV. Provider business mailing address

12770 MERIT DR STE 850
DALLAS TX
75251-1438
US

V. Phone/Fax

Practice location:
  • Phone: 512-462-3232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number34295
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: