MEDICARE: VINCENT P MORALES DC

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	111N00000X	Chiropractor	8721	TX

General Provider Information

NPI Number	:	1841434958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT P MORALES DC

Provider Business Mailing Address
First Line	:	660 S.W. MILITARY DR.
Second Line	:	SUITE P
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-1682
Country	:	US
Telephone Number	:	210-932-0507
Fax Number	:	210-932-0514

Provider Business Practice Location Address
First Line	:	660 S.W. MILITARY DR.
Second Line	:	SUITE P
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-1682
Country	:	US
Telephone Number	:	210-932-0507
Fax Number	:	210-932-0514

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

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	04/21/2009

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