Healthcare Provider Details

I. General information

NPI: 1922209733
Provider Name (Legal Business Name): KIMBERLY ANN MORAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BROOKLYN AVE STE 365
SAN ANTONIO TX
78212-4810
US

IV. Provider business mailing address

7940 FLOYD CURL DR STE 560
SAN ANTONIO TX
78229-3907
US

V. Phone/Fax

Practice location:
  • Phone: 210-224-9616
  • Fax: 210-224-5822
Mailing address:
  • Phone: 210-614-8100
  • Fax: 210-615-7233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD063875L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberN0291
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: