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General NPI Number Information
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NPI Number | 1356659585
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Entity Type | Individual
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Provider Name | MARCO MUNOZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 229 NE 28TH ST
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City | FORT WORTH
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State | TX
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Zip | 76164-7205
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Country | US
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Telephone | 817-566-0478
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Fax | 903-630-5456
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Provider Business Mailing Address
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Address Line | 300 E JOHN CARPENTER FWY SUITE 850
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City | IRVING
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State | TX
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Zip | 75062-2727
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Country | US
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Telephone | 972-957-3000
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Fax | 972-957-3005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD61553876
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N7564
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License Number State | TX
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