Healthcare Provider Details

I. General information

NPI: 1912596131
Provider Name (Legal Business Name): OPHELIA R MORALES CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 02/07/2021
Certification Date: 02/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23500 CIRCLE OAK PKWY
RICHMOND TX
77469-2509
US

IV. Provider business mailing address

2018 UPLAND PLOVER CT
ROSENBERG TX
77471-3281
US

V. Phone/Fax

Practice location:
  • Phone: 281-239-3731
  • Fax:
Mailing address:
  • Phone: 281-250-9092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number209421
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: