1245758085 NPI number — DR. ERNESTO FELIX MORALES DENTIST (IN MEXICO)

Table of content: DR. ERNESTO FELIX MORALES DENTIST (IN MEXICO) (NPI 1245758085)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245758085 NPI number — DR. ERNESTO FELIX MORALES DENTIST (IN MEXICO)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORALES
Provider First Name:
ERNESTO
Provider Middle Name:
FELIX
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DENTIST (IN MEXICO)
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1245758085
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 CANDLEWICK CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-455-1432
Provider Business Mailing Address Fax Number:
868-813-3107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE PRIMERA #253 COL. JARDIN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MATAMOROS
Provider Business Practice Location Address State Name:
TAMAULIPAS
Provider Business Practice Location Address Postal Code:
87330
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
956-455-1432
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/31/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  1886762 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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