Healthcare Provider Details

I. General information

NPI: 1790934545
Provider Name (Legal Business Name): FANNY ANDREA MORALES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FANNY ANDREA MORALES HYDER M.D.

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 07/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 BEE CAVES RD SUITE M-302
WEST LAKE HILLS TX
78746-5280
US

IV. Provider business mailing address

1004 SOUTH ROCK STREET WESTLAKE ANESTHESIA GROUP, PA
GEORGETOWN TX
78626
US

V. Phone/Fax

Practice location:
  • Phone: 512-697-3502
  • Fax: 512-697-3501
Mailing address:
  • Phone: 512-279-0348
  • Fax: 512-371-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberQ0981
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: