Provider Demographics
NPI:1194049874
Name:MUNGA, SUSAN W (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:W
Last Name:MUNGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7133
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387
Mailing Address - Country:US
Mailing Address - Phone:936-877-1044
Mailing Address - Fax:936-877-1056
Practice Address - Street 1:500 MEDICAL CENTER BLVD STE 335
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2960
Practice Address - Country:US
Practice Address - Phone:936-877-1044
Practice Address - Fax:936-877-1056
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3244207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ3244OtherTX LICENSE
TX349617601Medicaid
TX349617601Medicaid
410322YK6UMedicare PIN