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General NPI Number Information
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NPI Number | 1316514995
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Entity Type | Individual
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Provider Name | MARCIAL ARTURO MORENO GUTIERREZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 208 STARR ST
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City | MERCEDES
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State | TX
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Zip | 78570
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Country | US
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Telephone | 956-514-1643
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Fax | 718-963-7957
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Provider Business Mailing Address
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Address Line | 1010 JAMES ST SUITE B
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City | WESLACO
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State | TX
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Zip | 78596
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Country | US
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Telephone | 718-963-7956
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Fax | 718-963-7957
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | U9316
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License Number State | TX
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