Provider Demographics
NPI:1619222015
Name:MUNIZ, LEONIDES ALBERTO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LEONIDES
Middle Name:ALBERTO
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W ARBROOK BLVD
Mailing Address - Street 2:T-1339
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-4107
Mailing Address - Country:US
Mailing Address - Phone:817-557-2177
Mailing Address - Fax:
Practice Address - Street 1:1600 W ARBROOK BLVD
Practice Address - Street 2:T-1339
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4107
Practice Address - Country:US
Practice Address - Phone:817-557-2177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-21
Last Update Date:2012-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51737183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist