Individual provider Active NPI

Rick Munoz, OD

  • Optometrist
  • Odessa, TX
National Provider Identifier
1932181104
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5634T Issued in TX
Practice address
611 N Tom Green Ave
Odessa, TX 79761-4525
Phone
(432) 332-0616
Fax
(432) 332-6920
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5634T TX Primary

Addresses

Primary practice location

611 N Tom Green Ave
Odessa, TX 79761-4525

Mailing address

611 N Tom Green Ave
Odessa, TX 79761-4525
Phone (432) 332-0616

Other identifiers 1

IdentifierTypeStateIssuer
019118101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120927000472 TX Practitioner - Optometry 6608087846 Practice locations: Odessa, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

901 N Grant Ave
Suite 101
Odessa, TX 79761-4056
Phone (432) 332-0616

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5634TTXMDOptometrist
5637TTXMDCorneal and Contact Management Optometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1932181104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N TOM GREEN AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614525",
            "telephone_number": "432-332-0616",
            "fax_number": "432-332-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N TOM GREEN AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614525",
            "telephone_number": "432-332-0616",
            "fax_number": "432-332-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "RICK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5634T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019118101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.