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General NPI Number Information
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NPI Number | 1740829944
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Entity Type | Individual
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Provider Name | DIANA MORALES
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Gender | Female
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 1812 CENTRE CREEK DR STE 115
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City | AUSTIN
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State | TX
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Zip | 78754-5133
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Country | US
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Telephone | 512-579-0184
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 N GEORGETOWN ST APT 909
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City | ROUND ROCK
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State | TX
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Zip | 78664-3266
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Country | US
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Telephone | 512-850-9166
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 153095
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License Number State | TX
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