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NPI Code Detail

MEDICARE: PHILLIP A. MUNOZ MD

MEDICARE:   PHILLIP A. MUNOZ  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0101XAnatomic Pathology Physician04-19124KS
2207ZP0101XAnatomic Pathology PhysicianR2J39MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1662000006OTHERMOMEDICARE PTAN
3662A00007OTHERKSMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4R2J39OTHERMOMO LICENSE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
604-19124OTHERKSKANSAS LICENSE

General Provider Information

NPI Number : 1124092804
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP A. MUNOZ MD
Provider Business Mailing Address
First Line : 14275 MIDWAY RD
Second Line : SUITE 400
City : ADDISON
State : TX
Zip : 75001-3614
Country : US
Telephone Number : 214-932-8029
Fax Number : 610-271-4245
Provider Business Practice Location Address
First Line : 10330 HICKMAN MILLS DR
Second Line :
City : KANSAS CITY
State : MO
Zip : 64137-1618
Country : US
Telephone Number : 816-412-7004
Fax Number : 816-763-7536
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2006
Last Update Date : 12/11/2013

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Directions to “ PHILLIP A. MUNOZ MD” Practice Location

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