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General NPI Number Information
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NPI Number | 1356819155
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Entity Type | Individual
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Provider Name | BRENDA MORENO RN
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Gender | Female
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Dates
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Enumeration Date | 11/09/2018
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Last Update Date | 11/09/2018
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Provider Practice Location Address
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Address Line | 2058 BERGER RD
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City | VICTORIA
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State | TX
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Zip | 77905-5208
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Country | US
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Telephone | 361-550-8856
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Fax |
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Provider Business Mailing Address
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Address Line | 123 COUNTY RD
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City | VICTORIA
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State | TX
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Zip | 77905-1300
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Country | US
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Telephone | 832-783-0808
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 949461
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License Number State | TX
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