1649439365 NPI number — FRANCISCO E. MORENO M.D., P.A.

Table of content: (NPI 1649439365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649439365 NPI number — FRANCISCO E. MORENO M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANCISCO E. MORENO M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KATY MEMORIAL PEDIATRICS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649439365
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23920 KATY FWY
Provider Second Line Business Mailing Address:
#310
Provider Business Mailing Address City Name:
KATY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77494-1341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-392-8920
Provider Business Mailing Address Fax Number:
281-392-6950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23920 KATY FWY
Provider Second Line Business Practice Location Address:
#310
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77494-1341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-392-8920
Provider Business Practice Location Address Fax Number:
281-392-6950
Provider Enumeration Date:
06/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MORENO
Authorized Official First Name:
FRANCISCO
Authorized Official Middle Name:
EUGENIO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
281-392-8920

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  F1838 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 154681401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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