MEDICARE: HEATHER L MUNIZ PROVIDER

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
1	251E00000X	Home Health Agency	343289	TX

General Provider Information

NPI Number	:	1720390792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER L MUNIZ PROVIDER

Provider Business Mailing Address
First Line	:	3421 NORTH VERONICA LANE
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78542
Country	:	US
Telephone Number	:	956-316-4747
Fax Number	:

Provider Business Practice Location Address
First Line	:	3421 NORTH VERONICA LANE
Second Line	:
City	:	ENDINBURG
State	:	TX
Zip	:	78542
Country	:	US
Telephone Number	:	956-239-5828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2010
Last Update Date	:	09/09/2010

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