Healthcare Provider Details

I. General information

NPI: 1942966015
Provider Name (Legal Business Name): SARA MORALES NREMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 HARMON DR
NORTHFIELD VT
05663-1035
US

IV. Provider business mailing address

2611 PIPING ROCK TRL
AUSTIN TX
78748-5944
US

V. Phone/Fax

Practice location:
  • Phone: 512-797-2933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number763680
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2000050620
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: