Healthcare Provider Details

I. General information

NPI: 1861593220
Provider Name (Legal Business Name): ALEXIS MUNIZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3326 WATTERS RD BLD C
PASADENA TX
77504-2020
US

IV. Provider business mailing address

3326 WATTERS RD BLD C
PASADENA TX
77504-2020
US

V. Phone/Fax

Practice location:
  • Phone: 713-941-6610
  • Fax: 713-941-6846
Mailing address:
  • Phone: 713-941-6610
  • Fax: 713-941-6846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG4176
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: