Healthcare Provider Details

I. General information

NPI: 1720456486
Provider Name (Legal Business Name): CARLOS MANUEL MORALES RODRIGUEZ PHD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E HACKBERRY AVE
MCALLEN TX
78501-6502
US

IV. Provider business mailing address

901 E HACKBERRY AVE
MCALLEN TX
78501-6502
US

V. Phone/Fax

Practice location:
  • Phone: 956-618-7100
  • Fax:
Mailing address:
  • Phone: 956-618-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number005953
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: