1932300332 NPI number — DR. FEDERICO EUSEBIO MORON PHARMD

Table of content: DR. FEDERICO EUSEBIO MORON PHARMD (NPI 1932300332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932300332 NPI number — DR. FEDERICO EUSEBIO MORON PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORON
Provider First Name:
FEDERICO
Provider Middle Name:
EUSEBIO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
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:
1932300332
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2601 SARAH AVE
Provider Second Line Business Mailing Address:
APT 343
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78503-8712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-529-8371
Provider Business Mailing Address Fax Number:
956-583-2700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1242 E BUSINESS HIGHWAY 83
Provider Second Line Business Practice Location Address:
STE 7
Provider Business Practice Location Address City Name:
MISSION
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78572-9310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-583-2700
Provider Business Practice Location Address Fax Number:
956-583-2714
Provider Enumeration Date:
05/31/2007

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: 183500000X , with the licence number:  42314 , 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)





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