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General NPI Number Information
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NPI Number | 1558713800
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Entity Type | Organization
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Legal Business Name | MUNIR F BISHARA, M.D.
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 616 CLINTON ST
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City | OVILLA
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State | TX
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Zip | 75154-5577
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Country | US
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Telephone | 972-515-8802
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Fax |
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Provider Business Mailing Address
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Address Line | 616 CLINTON ST
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City | OVILLA
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State | TX
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Zip | 75154-5577
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Country | US
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Telephone | 972-515-8802
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Fax |
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | MUNIR FARIZ BISHARA
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Credential | M.D.
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Telephone | 972-515-8802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | D8862
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License Number State | TX
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