Basic Information
| Provider Information | |||||||||
| NPI: | 1164199873 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUNOZ | ||||||||
| FirstName: | PATRICA | ||||||||
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| Credential: | OTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4444 CORONA DR STE 144 | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784114322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618541110 | ||||||||
| FaxNumber: | 8554489769 | ||||||||
| Practice Location | |||||||||
| Address1: | 4444 CORONA DR STE 144 | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784114322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618541110 | ||||||||
| FaxNumber: | 8554489769 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2021 | ||||||||
| LastUpdateDate: | 08/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 215428 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.