Individual
NICOLETTE DANIELLE MUNOZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 S STEWART RD STE D, SAN JUAN, TX 78589-5168
(956) 283-7555
Mailing address
712 LYNN DR, EDINBURG, TX 78539-7042
(512) 589-8922
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2132920
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132920
TEXAS STATE BOARD LICENSE
TX
Enumeration date
01/29/2018
Last updated
01/29/2018
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