Healthcare Provider Details

I. General information

NPI: 1841320694
Provider Name (Legal Business Name): PAMELA MUNOZ ASST SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W EDINBURG AVE
ELSA TX
78543-1769
US

IV. Provider business mailing address

RR 13 BOX 1216
EDINBURG TX
78541-8994
US

V. Phone/Fax

Practice location:
  • Phone: 956-262-1037
  • Fax:
Mailing address:
  • Phone: 956-381-8641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number33622
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: