Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | Q5046 | TX |
Y | 111NI0900X | Internist | Q5046 | TX |
NPI | 1003158411 |
---|---|
Provider Name | Dr. Brenna Michell Muniz |
First Address | Pearland, TX 77584-7298 |
Second Address | Houston, TX 77065-5611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2013 |
Last Update Date | 14/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
361505601 | (05) | TX |