Provider Demographics
NPI:1356523443
Name:MUNSON, KEVIN AARON (OD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:AARON
Last Name:MUNSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 S LAKE FOREST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2238
Mailing Address - Country:US
Mailing Address - Phone:214-363-5991
Mailing Address - Fax:866-573-0828
Practice Address - Street 1:5900 S LAKE FOREST DR STE 300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2238
Practice Address - Country:US
Practice Address - Phone:214-363-5991
Practice Address - Fax:866-573-0828
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3087152W00000X
TX6139TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200925060AMedicaid
TX307935202Medicaid