Healthcare Provider Details

I. General information

NPI: 1295415461
Provider Name (Legal Business Name): SHERI KATHLEEN MORALEZ RN, CCM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13604 AVENUE W
LUBBOCK TX
79423-1282
US

IV. Provider business mailing address

12337 JONES RD STE 100
HOUSTON TX
77070-4844
US

V. Phone/Fax

Practice location:
  • Phone: 806-239-0718
  • Fax:
Mailing address:
  • Phone: 806-252-6736
  • Fax: 877-215-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number734772
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: