Individual
JOHN D MUCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
6550 FANNIN ST, SUITE 1101, HOUSTON, TX 77030-2717
(713) 441-0006
(713) 790-6617
Mailing address
6550 FANNIN ST, SUITE 1101, HOUSTON, TX 77030-2717
(713) 441-0006
(713) 790-6617
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326086778
BLUE CROSS BLUE SHIELD
TX
05
—
204590802
—
TX
01
—
8Y0410
BCBS
TX
01
—
P01078375
RR MEDICARE
TX
Enumeration date
06/04/2006
Last updated
11/01/2012
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