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PHILLIP A. MUNOZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10330 HICKMAN MILLS DR, KANSAS CITY, MO 64137-1618
(816) 412-7004
(816) 763-7536
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(214) 932-8029
(610) 271-4245

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
04-19124
KS
207ZP0101X
Anatomic Pathology Physician
R2J39
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-19124
KANSAS LICENSE
KS
05
100124790F
KS
05
1124092804
MO
01
662000006
MEDICARE PTAN
MO
01
662A00007
MEDICARE PTAN
KS
01
R2J39
MO LICENSE
MO
Enumeration date
02/17/2006
Last updated
12/11/2013
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