Healthcare Provider Details

I. General information

NPI: 1821239492
Provider Name (Legal Business Name): MORA CARES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13737 HIGHWAY 36
NEEDVILLE TX
77461-7516
US

IV. Provider business mailing address

13737 HIGHWAY 36
NEEDVILLE TX
77461-7516
US

V. Phone/Fax

Practice location:
  • Phone: 979-793-3940
  • Fax: 979-793-3945
Mailing address:
  • Phone: 979-793-3940
  • Fax: 979-793-3945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL1944
License Number StateTX

VIII. Authorized Official

Name: DR. YEZID FERNANDO MORA
Title or Position: OWNER
Credential: M.D.
Phone: 979-793-3940