MEDICARE: CARLOS A MORALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	20492	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649287434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS A MORALES

Provider Business Mailing Address
First Line	:	2395 E DEL MAR BLVD UNIT 451795
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-0174
Country	:	US
Telephone Number	:	956-285-2166
Fax Number	:

Provider Business Practice Location Address
First Line	:	1803 N US HIGHWAY 83 STE 2
Second Line	:
City	:	ZAPATA
State	:	TX
Zip	:	78076-3526
Country	:	US
Telephone Number	:	956-413-8585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	02/07/2025

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Directions to “ CARLOS A MORALES ” Practice Location

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