Moriah Munoz

Individual provider Active NPI Occupational Therapy Assistant · Fairfield, TX

NPI 1083175814 · NPPES record last updated Mar 26, 2019

Key facts

NPI
1083175814
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
214324 (TX)
Practice address
420 Moody St
Fairfield, TX 75840-3036
Phone
(903) 389-1236
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
214324TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 214324 TX Yes

Addresses

Primary practice location

420 Moody St
Fairfield, TX 75840-3036

Mailing address

108 FCR 430
Buffalo, TX 75831-6842

Other providers in Fairfield, TX

All providers in Fairfield, TX · Occupational Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.