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General NPI Number Information
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NPI Number | 1023559424
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Entity Type | Individual
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Provider Name | JOHN CHRISTOPHER MORENO PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 03/17/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 1779 N ZARAGOZA RD STE. A
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City | EL PASO
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State | TX
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Zip | 79936-8027
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Country | US
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Telephone | 915-855-6466
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Fax | 915-855-6181
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Provider Business Mailing Address
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Address Line | 1779 N ZARAGOZA RD STE. A
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City | EL PASO
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State | TX
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Zip | 79936-8027
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Country | US
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Telephone | 915-855-6466
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Fax | 915-855-6181
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1287187
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License Number State | TX
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