Individual
DEREK REY MUNOZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2551 GREENWOOD RD STE 410, SHREVEPORT, LA 71103
(186) 212-9293
(318) 638-3169
Mailing address
2551 GREENWOOD RD STE 410, SHREVEPORT, LA 71103-3989
(186) 212-9293
(318) 638-3169
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
312879
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2016
Last updated
08/30/2019
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