Healthcare Provider Details

I. General information

NPI: 1154867240
Provider Name (Legal Business Name): MARTHA MUNIZ ZAVALA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHA MUNIZ

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 08/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 N MACARTHUR BLVD STE 500
IRVING TX
75062-3675
US

IV. Provider business mailing address

PO BOX 612526
DALLAS TX
75261-2526
US

V. Phone/Fax

Practice location:
  • Phone: 972-256-3700
  • Fax: 866-630-6348
Mailing address:
  • Phone: 972-256-3700
  • Fax: 866-630-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP134708
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: